RESUMO
The main surgical techniques used to remove ear canal exostoses are drilling and/or, chiselling. The aim of this study was to identify the origins and subsequent evolution of, the surgical removal of ear canal exostoses in the 19th century. A critical review and, compilation of primary and secondary historical sources was conducted. Two techniques for removal of exostoses were developed in the latter part of the 19th century and have largely remained unchanged. This demonstrates the importance of that era in the history of ear surgery.
Assuntos
Meato Acústico Externo/cirurgia , Exostose/cirurgia , Procedimentos Cirúrgicos Otológicos/história , Instrumentos Cirúrgicos/história , Otopatias/cirurgia , História do Século XVIII , História do Século XIX , Humanos , Procedimentos Cirúrgicos Otológicos/instrumentaçãoAssuntos
Queimaduras/patologia , Ablação por Cateter/instrumentação , Eletrocoagulação/instrumentação , Complicações Intraoperatórias/patologia , Tonsila Palatina/patologia , Instrumentos Cirúrgicos , Tonsilectomia/instrumentação , Desenho de Equipamento , Humanos , Microdissecção/instrumentação , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controleRESUMO
OBJECTIVES/HYPOTHESIS: This study was undertaken to assess a transcanal osteotome technique for removing symptomatic ear canal exostoses. Outcome measures included healing rates and the rate of complications. STUDY DESIGN: Prospective study in a private practice. METHODS: A straight 1-mm osteotome and a curved 1-mm osteotome were used by way of a transcanal approach to incrementally remove obstructive ear canal exostoses. If anterior or superior bone growths were closely approximating the tympanic membrane, they were partially removed with a 1.5 mm cylindrical end- and side-cutting burr. Healing rates were monitored with weekly postoperative visits. RESULTS: Two hundred twenty-one ear canals (140 patients) were consecutively treated with this technique. Healing was achieved at 2 to 8 (average 3.50) weeks, with 90% healed by 4 weeks. There were 4 mobilizations of a full-thickness segment of anterior bony canal wall; 3 exposures of periosteum anterior to the anterior bony wall; 1 tear of the tympanic membrane requiring a tympanoplasty; 18 anterior and 11 posterior tympanic membrane tears that healed spontaneously; 3 instances of sensorineural hearing decrease; 3 cases of new-onset postoperative tinnitus; and 1 instance of postoperative positioning vertigo. There were no lacerations of the tympanic membrane by an osteotome, no facial nerve injuries, no soft tissue stenoses of an ear canal, and no skin grafting of an ear canal. CONCLUSIONS: The described technique of using osteotomes transcanal for removal of symptomatic obstructive ear canal exostoses promoted rapid healing and was effective and safe.
