Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection

Moss, William J.; Lin, Harrison W.; Cueva, Roberto A.

doi:10.1177/0003489415595238

Cited by 5 publications

(18 citation statements)

References 11 publications

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“…Minimizing trauma to the native EAC skin during surgery and preserving its vasculature is critical to allow for postoperative EAC healing. 13 While one patient developed thermal injury due to the ultrasonic serrated knife which resulted in slower ear canal healing, our study indicated that the process of ear canal healing was overall unchanged when compared to a micro-osteotome only technique. This occurred in the first patient in our series.…”

Section: Discussionmentioning

confidence: 65%

“…The rate of intraoperative complications from the different surgical methods has been shown to be overall low. 6,13,19,20 Our standard transcanal excision of exostoses with micro-osteotome only similarly demonstrates an overall low rate of complications (6.3%) with an even lower rate with the transcanal use of Sonopet (0%), despite this patient population having a higher rate of preoperative stenosis.…”

Section: Discussionmentioning

confidence: 80%

“…Multiple intra-operative complications to exostoses have been described, including facial nerve injury, TM perforation, temporomandibular joint (TMJ) injury, anterior canal wall mobilization, and mastoid air cell entry. 9,13,14,17 Other postoperative complications include sensorineural hearing loss, facial paralysis, TM lateralization, chronic myringitis, wound infection, hematoma/seroma, canal swelling, prolonged healing, exposed bone, canal stenosis, and the need for revision surgery. 9,10,13,18 Surgery requires preservation of EAC skin over the exostoses to allow for appropriate EAC healing.…”

Section: Discussionmentioning

confidence: 99%

“…While it is certainly a concern with vibration injury during the drilling process 13,21 , it is less likely to be of concern with the ultrasonic system. The ultrasonic serrated knife has decreased sound transmission in the range of human hearing compared to a drill as well as improved tactile feedback.…”

Section: Discussionmentioning

confidence: 99%

“…13–16 While there have been decreasing rates of intra-operative complications and improved postoperative healing with more recently described methods, exostoses excision continues to present a surgical challenge to otolaryngologists. Exostoses demonstrate a variable shape and broad bases which can make excision difficult.…”

Section: Introductionmentioning

confidence: 99%

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The Use of an Ultrasonic Serrated Knife in Transcanal Excision of Exostoses

Haidar¹,

Ajose-Popoola²,

Mahboubi³

et al. 2016

Otology &Amp; Neurotology

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Objective To describe a novel approach for excision of exostoses and evaluate the outcomes of transcanal excision of exostoses using ultrasonic serrated knife-assistance vs. micro-osteotomes only. Study Design Retrospective analysis Setting Academic Tertiary Care Center Patients/Interventions Patients receiving a transcanal excision of exostoses between 2007 and 2016. Main outcome measures The outcomes and post-operative complications of 138 patients who received transcanal micro-osteotome only technique were compared to 10 patients who received transcanal excision of exostoses using ultrasonic serrated knife-assistance (Stryker Corporation, Kalamazoo, MI). Results A total of 175 ears in 128 patients underwent a transcanal micro-osteotome only technique. Of these, 11 (6.3%) developed an intra-operative tympanic membrane perforation. One developed anterior canal mobilization requiring prolonged (3 weeks) packing. One hundred and thirty five ears (77%) were well healed by the three week post-operative visit. All but one ear was well healed by the six week visit. In comparison, 11 ears in 10 patients were treated for exostoses using a transcanal approach with the use of ultrasonic serrated knife and micro-osteotomes. One ear canal (the first in the series) was not well healed by the three week post-operative visit due to suspected thermal injury. All patients had well healed ear canals by six weeks, and there were no complications. Conclusions This is the first series to report the use of an ultrasonic serrated knife in the transcanal excision of exostoses. When compared to a transcanal micro-osteotome only excision of exostoses, the addition of the Sonopet appears to result in a similarly low complication rate. Sonopet can allow for more controlled transcanal excision of broad based exostoses in patients with severe obstruction.

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Section: Discussionmentioning

confidence: 65%