EXFOLIATIVE TREPAN

\ɛksfˈə͡ʊli͡ətˌɪv tɹˈɛpan], \ɛksfˈə‍ʊli‍ətˌɪv tɹˈɛpan], \ɛ_k_s_f_ˈəʊ_l_iə_t_ˌɪ_v t_ɹ_ˈɛ_p_a_n]\
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1846 - Medical lexicon: a dictionary of medical science
By Robley Dunglison