Chin-Kuo Chen1, Kai-Ping Chang2, Chen-Yu Chien3, Li-Chun Hsieh4. 1. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan; Communication Enhancement Center, Chang Gung Memorial Hospital, Tao-Yuan, Taiwan. 2. Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan; College of Medicine, Chang Gung University, Tao-Yuan, Taiwan. 3. Department of Otorhinolaryngology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Otorhinolaryngology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. 4. Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Department of Audiology and Speech Language Pathology, Mackay Medical College, Taiwan. Electronic address: lichunhsieh1978@gmail.com.
Abstract
BACKGROUND: External auditory canal (EAC) osteomas are rare, slow-growing benign neoplasms. Microscopic surgical excision had been reported for symptomatic osteomas. However, there was no study published on the feasibility of transcanal endoscopic ear surgery (TEES) for EAC osteoma. In this study, we propose two methods of TEES for symptomatic EAC osteomas and report the surgical outcomes of our patients. METHODS: Fifteen patients diagnosed with symptomatic EAC osteoma who underwent TEES were recruited at two otolaryngology referral centers. The extent of osteoma and degree of EAC stenosis was calculated based on high-resolution computed tomography (HRCT) imaging. We divided all the patients into two groups, solitary pedunculated osteoma or broad-based osteomas. The postoperative outcomes and complications were recorded for at least 6 months of outpatient follow-up. RESULTS: In this study, twelve patients with solitary osteoma underwent the first method, a direct transcanal removal procedure. In this approach, only a small bare bony area remained postoperatively, and it healed completely within 1 month. Three patients with broad based osteoma underwent the second method, a transcanal approach involving a skin flap. The degree of stenosis in all patients ranged from 29% to 90%. All of them could be treated completely through a transcanal endoscopic approach. No intraoperative or postoperative complications were noted during follow-up, and no canal stenosis and no recurrences were noted during at least 6 months of follow-up. CONCLUSIONS: This endoscopic transcanal approach to EAC osteomas demonstrated good results for lesion removal without recurrence or intraoperative complications.
BACKGROUND: External auditory canal (EAC) osteomas are rare, slow-growing benign neoplasms. Microscopic surgical excision had been reported for symptomatic osteomas. However, there was no study published on the feasibility of transcanal endoscopic ear surgery (TEES) for EAC osteoma. In this study, we propose two methods of TEES for symptomatic EAC osteomas and report the surgical outcomes of our patients. METHODS: Fifteen patients diagnosed with symptomatic EAC osteoma who underwent TEES were recruited at two otolaryngology referral centers. The extent of osteoma and degree of EAC stenosis was calculated based on high-resolution computed tomography (HRCT) imaging. We divided all the patients into two groups, solitary pedunculated osteoma or broad-based osteomas. The postoperative outcomes and complications were recorded for at least 6 months of outpatient follow-up. RESULTS: In this study, twelve patients with solitary osteoma underwent the first method, a direct transcanal removal procedure. In this approach, only a small bare bony area remained postoperatively, and it healed completely within 1 month. Three patients with broad based osteoma underwent the second method, a transcanal approach involving a skin flap. The degree of stenosis in all patients ranged from 29% to 90%. All of them could be treated completely through a transcanal endoscopic approach. No intraoperative or postoperative complications were noted during follow-up, and no canal stenosis and no recurrences were noted during at least 6 months of follow-up. CONCLUSIONS: This endoscopic transcanal approach to EAC osteomas demonstrated good results for lesion removal without recurrence or intraoperative complications.