Haidar Yarah M, Ajose-Popoola Olubunmi, Mahboubi Hossein, Moshtaghi Omid, Ghavami Yaser, Lin Harrison W, Djalilian Hamid R
*Department of Otolaryngology-Head and Neck Surgery †Department of Biomedical Engineering, Division of Neurotology and Skull Base Surgery, University of California, Irvine Medical Center, Irvine, California.
Otol Neurotol. 2016 Oct;37(9):1418-22. doi: 10.1097/MAO.0000000000001170.
To describe a novel approach for excision of exostoses and evaluate the outcomes of transcanal excision of exostoses using ultrasonic serrated knife-assistance versus microosteotomes only.
Retrospective analysis.
Academic Tertiary Care Center.
PATIENTS/INTERVENTIONS: Patients receiving a transcanal excision of exostoses between 2007 and 2016.
The outcomes and postoperative complications of 138 patients who received transcanal microosteotome only technique were compared to 10 patients who received transcanal excision of exostoses using ultrasonic serrated knife-assistance (Stryker Corporation, Kalamazoo, MI).
A total of 175 ears in 128 patients underwent a transcanal microosteotome only technique. Of these, 11 (6.3%) developed an intraoperative tympanic membrane perforation. One developed anterior canal mobilization requiring prolonged (3 wk) packing. One hundred thirty-five ears (77%) were well healed by the 3-week postoperative visit. All but one ear was well healed by the 6-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 microosteotomes. One ear canal (the first in the series) was not well healed by the 3-week postoperative visit due to suspected thermal injury. All patients had well-healed ear canals by 6 weeks, and there were no complications.
This is the first series to report the use of an ultrasonic serrated knife in the transcanal excision of exostoses. When compared with a transcanal microosteotome only excision of exostoses, the addition of the Sonopet seems 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.
描述一种切除外生骨疣的新方法，并评估使用超声锯齿刀辅助经耳道切除外生骨疣与仅使用微型骨凿的效果。
回顾性分析。
学术性三级医疗中心。
患者/干预措施：2007年至2016年间接受经耳道切除外生骨疣的患者。
将138例仅接受经耳道微型骨凿技术的患者的治疗效果和术后并发症与10例接受超声锯齿刀辅助（史赛克公司，密歇根州卡拉马祖）经耳道切除外生骨疣的患者进行比较。
128例患者共175耳接受了仅经耳道微型骨凿技术。其中，11例（6.3%）发生术中鼓膜穿孔。1例出现前耳道松动，需要长时间（3周）填塞。135耳（77%）在术后3周复诊时愈合良好。除1耳外，所有耳在术后6周复诊时均愈合良好。相比之下，10例患者的11耳采用经耳道方法并使用超声锯齿刀和微型骨凿治疗外生骨疣。由于怀疑有热损伤，1耳在术后3周复诊时愈合不佳。所有患者在6周时耳道均愈合良好，且无并发症。
这是首个报道在经耳道切除外生骨疣中使用超声锯齿刀的系列研究。与仅经耳道微型骨凿切除外生骨疣相比，添加Sonopet似乎导致类似的低并发症发生率。Sonopet可使严重阻塞患者更可控地经耳道切除宽基外生骨疣。
