Surgical treatment of external auditory canal exostoses

Background: Although complications of surgical removal of external auditory canal exostoses are rare, reported surgical complications include tympanic membrane perforation, postoperative hearing loss, canal stenosis, and faci al nerve injuries. Patients and Methods: We report on our experience in exo stosis surgery, consisting of 59 procedures in 48 patients. Preoperative an d postoperative complaints and findings, intraoperative complications, and audiologic results are described and discussed. There has been a minimum of one year of follow-up in every case. Results: Postoperative canal stenosis was seen in 2 cases of preoperative severe persistent external otitis. Tem porary threshold shift was recorded in 6 patients. Persistent sensorineural hearing loss occurred in 4 patients. Six of the 10 patients with temporary or persistent hearing loss had already shown preoperative sensorineural he aring loss. Intraoperatively tympanic membrane perforation occurred in 3 ca ses, accidential opening of the mastoid in 1 case. Conclusions: Exostosis s urgery should be reserved for uninfected ear canals. Meatal skin preservati on without circular meatal flap incision is recommended to avoid postoperat ive canal stenosis. Especially in cases of preexisting sensorineural hearin g loss, attention should be focused on the intraoperative noise reduction b y tympanic membrane protection and pauses of noise exposition.