The Swansea Technique: a novel method of endoscopic underwater excision of external auditory canal exostoses using a piezoelectric saw.

BACKGROUND: External auditory exostosis (surfer's ear) is a progressive condition of benign hyperostotic overgrowths of the external auditory canal, secondary to repetitive cold-water exposure, in which symptoms correlate to degree of exostosis. Surgical intervention is the only available treatment, most commonly using the osteotome or microdrill, but these carry a risk of sensorineural hearing loss, post-operative stenosis, temporomandibular dysfunction and tympanic membrane perforation.

METHODS: We describe in detail the Swansea technique, an innovative method of canaloplasty with endoscopic underwater excision of exostoses using a piezoelectric saw and continuous irrigation with 1:1,000,000 adrenaline, with the results from our first 34 procedures.

RESULTS: The inherent properties of the piezoelectric saw reduce the risk of overall complications when compared with traditional methods, whilst the surgical set-up is cost-equivocal and easily implemented in departments with endoscopic capabilities.

CONCLUSION: The piezoelectric saw is a promising novel technique for the treatment of external auditory exostosis.