External Auditory Canal Cholesteatoma: Clinical and Radiological Features

Abstract

Introduction External auditory canal cholesteatoma (EACC) is often misdiagnosed. Objectives To outline the clinical presentation of EACC, and to describe its radiological findings on high-resolution computed tomography (HRCT) of the temporal bone. Methods The clinical records of all patients diagnosed with EACC from April 2017 to March 2020 in a tertiary care center were retrospectively reviewed. The clinical presentation, the findings on the HRCT of the temporal bone, and the treatment provided were analyzed. Results A total of 9 patients, 7 males and 2 females, with a mean age of 30 years, were diagnosed with primary EACC. Six patients presented with otorrhoea, three, with otalgia, three. with hearing loss, and one with facial palsy. Some patients had multiple symptoms. The most common findings on otomicroscopy were destruction of the posterior and inferior canal walls, with cholesteatoma and intact tympanic membrane (six patients). Two patients had aural polyp, and one had a narrow ear canal due to sagging of the posterior canal wall. On HRCT, all nine patients showed soft-tissue density in the external auditory canal with erosion of the canal wall. The disease extended to the mastoid in eight cases, and to the cavity of the middle ear in one. There were three cases of dehiscence of the facial canal. Dehiscence of the dural and sinus plates was observed in two cases each. Eight patients underwent mastoidectomy, and one underwent debridement with canalplasty. Conclusion Review of the clinical and radiological findings is essential to reduce the rate of misdiagnosis.

Recurrent Ear Discharge in Primary Care: Exploring the Possibility of Cholesteatoma - A Case Report

“…Nevertheless, there has been reports to debunk the age factor. 5 Another feature that about one fifth of patients have are a group of symptoms of otorrhea, tinnitus and hearing impairment, was not present in this patient. 3 Having said this, this case also showed the usual symptoms of pain and otorrhea in EECC.…”

Cholesteatoma of the auditory canal complicated by retroauricular abscess

“…El examen imagenológico de elección es la tomografía computarizada (TC) de oídos. El caso aquí presentado se ajusta a su presentación habitual correspondiente a una imagen de densidad de tejidos blandos que erosiona el CAE con una membrana timpánica generalmente conservada y un oído medio intacto (9).…”

Modified—modified radical mastoidectomy

“…Studies show that while keratosis obturans progresses through TM to the tympanum, EAC cholesteatoma progresses to the mastoid by destroying the posterior EAC [ 3 , 7 ]. Our patient did not give history suggestive of either of these two diseases, thus ruling them out.…”

“…Tragal cartilage with intact perichondrium may also be used [ 4 ]. Canal wall-down mastoid surgery with or without EAC reconstruction is another treatment option [ 6 , 7 ].…”