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Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection

Background: External auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery. Objective: To perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection. Study Design: Retrospective review. Subjects and Methods: Thirty-four patients (41 ears) underwent canalplasty from 2008 to 2014 at a tertiary referral center. Primary outcome measures included rates of prolonged healing and restenosis, need for revision surgery, and audiometric results. Rates of intraoperative and postoperative complications were also tabulated. Results: No patient experienced recurrent stenosis or required a revision surgery within the follow-up period. All but one patient (97%) achieved complete healing within 8 weeks. Minimal intraoperative complications were found. Statistically significant improvements in air pure tone averages and air-bone gaps were achieved. Conclusion: The proposed technique is a safe and effective method of canalplasty for exostoses that imparts accelerated wound healing and minimizes the rate of recurrent stenosis.