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The Sanu Technique: a technical note describing a novel method of
endoscopic underwater excision of external auditory canal exostoses
using Piezoelectric Saw.
Abstract
Key Points: 1. 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. 2. 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. 3. We describe the Sanu technique, an innovative
method of canaloplasty with endoscopic underwater excision of exostoses
using Piezoelectric saw and continuous irrigation with 1:1,000,000
adrenaline. 4. The inherent properties of the Piezoelectric saw reduce
the overall risk of complications compared to otologic drill and
osteotome, most notably of sensorineural hearing loss and
temporomandibular joint dysfunction. 5. This novel technique is
cost-equivocal and easily implemented in departments with endoscopic
capabilities.