External auditory exostoses: evaluation and treatment.

OBJECTIVE: To determine (1) if external auditory exostosis (EAE) severity in a surgical exostosis population differs between ears and (2) the incidence of complications from postauricular canalplasty for EAE.

STUDY DESIGN: A retrospective review.

SUBJECTS AND METHODS: Three hundred twenty-seven patients (401 ears) underwent drill canalplasty for EAE from 1990 to 2006. EAE severity was graded, and air and bone thresholds were used to evaluate hearing changes.

RESULTS: There were no significant differences in surgery rate or severity between right and left ears (71% grade 3 in both ears), with 95 percent grade 3 in operated ears. Prolonged healing occurred in 4.5 percent, with 1 TM perforation (0.2%). Sensorineural hearing at 4 kHz worsened slightly (mean change = 3.7 dB, P < or = 0.001), with 4.8 percent worsening >15 dB (maximum 30 dB), but sensorineural bone average was unchanged (mean = 0.2 dB). EAE recurred in 8 of 91 ears with long-term follow-up, occurring up to 15 years postsurgery.

CONCLUSIONS: EAE severity in surgical patients does not differ between right and left ears. Drill canalplasty via the postauricular approach minimizes complications.