Frese K A, Rudert H, Maune S
Klinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Christian-Albrechts-Universität zu Kiel.
Laryngorhinootologie. 1999 Oct;78(10):538-43. doi: 10.1055/s-1999-8754.
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 facial nerve injuries.
We report on our experience in exostosis surgery, consisting of 59 procedures in 48 patients. Preoperative and 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.
Postoperative canal stenosis was seen in 2 cases of preoperative severe persistent external otitis. Temporary 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 hearing loss. Intraoperatively tympanic membrane perforation occurred in 3 cases, accidental opening of the mastoid in 1 case.
Exostosis surgery should be reserved for uninfected ear canals. Meatal skin preservation without circular meatal flap incision is recommended to avoid postoperative canal stenosis. Especially in cases of preexisting sensorineural hearing loss, attention should be focused on the intraoperative noise reduction by tympanic membrane protection and pauses of noise exposition.
尽管外耳道外生骨疣手术切除的并发症很少见，但报告的手术并发症包括鼓膜穿孔、术后听力损失、外耳道狭窄和面神经损伤。
我们报告了我们在外生骨疣手术方面的经验，包括对48例患者进行的59例手术。描述并讨论了术前和术后的症状及检查结果、术中并发症以及听力检查结果。每例患者至少随访一年。
术前患有严重持续性外耳道炎的2例患者出现术后外耳道狭窄。6例患者记录到暂时性阈移。4例患者出现持续性感音神经性听力损失。10例有暂时性或持续性听力损失的患者中，有6例术前已存在感音神经性听力损失。术中3例发生鼓膜穿孔，1例意外打开乳突。
外生骨疣手术应仅用于未感染的外耳道。建议保留外耳道皮肤且不做环形外耳道皮瓣切口，以避免术后外耳道狭窄。特别是在已有感音神经性听力损失的病例中，应通过保护鼓膜和暂停噪声暴露来关注术中降噪。
