The Gruppo Otologico, Italy
Title: Outcomes of Drill Canalplasty in Exostoses and Osteoma: Analysis of 256 Cases and Literature Review Outcomes of Drill Canalplasty in Exostoses and Osteoma: Analysis of 256 Cases and Literature Review
Clinical Fellow in Otology, Neurotology & Skull Base Surgery at The Gruppo Otologico, Piacenza, Italy under Prof. Mario Sanna guidance. ENT specialist at Hillel Yaffe Hospital, Affiliated to the Technion University in Haifa, Hadera, Israel. Residency of Otorhinolaryngology, Head and Neck Surgery Department, Hadassah Ein Karem Hospital, Jerusalem, Israel. During the period I wrote scientific work under the guidance of prof. Sohmer ' Acoustic activation in the presence of an immobilized stapes, oval window and round window' Residency of Otorhinolaryngology, Head and Neck Surgery Department at Sheba Hospital. During the period I accepted the Tel Hashomer Award of Honourable Resident. Internship at Beilinson Hospital, which included elective in Otorhinolaryngology both in Tel Hashomer, Meir and Beilinson.
Objective: To describe the surgical technique of drill canaplasty for exostosis and osteoma and to evaluate our results. To propose a new grading system for external auditory canal stenosis (EACS).
Subjects and Methods: Two hundred seventeen patients (256 ears) with exostosis or osteoma were included in the study. Surgical and audiological parameters were evaluated. Results: Mean age was 51.5 (13.41) years. One hundred sixty-nine cases were men and 48 women. Two hundred forty-three (95%) cases were exostosis and 13 (5%) were osteomas. According to the proposed grading system, 81% ears had severe or complete stenosis. Seventy-eight (30.5%) ears had a concurrent diagnosis of otosclerosis. Retroauricular approach was used in 245 (95.7%). Intraoperative complications included tympanic membrane (TM) perforation seen in four (2%) and mastoid cell exposure in two (1%). Postoperative stenosis/prolonged healing was seen in 11 (4%) patients and required revision in seven cases. Audiologic analysis available for 153 ears-showed the mean change in air-bone gaps (ABG) of 2.18 dB, pure tone averages (PTA) bone conduction BC (0.5–4 kHz) of 0.3 db. Mean healing rate was available for 246 (96.1%) patients and was found to be 6.35 (4–16) weeks. Conclusion: A systematically performed drill canalplasty via retroauricular approach, as described in this article, yields excellent postoperative outcomes as seen in our series. Notably, one-third of exostoses patients in this series, also suffered from otosclerosis. The proposed grading system for EACS enables the surgeon to objectively stage the disease.