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Operative management of external auditory canal cholesteatoma: case series and literature review

Published online by Cambridge University Press:  20 August 2013

M Sayles*
Affiliation:
Department of Otorhinolaryngology - Head and Neck Surgery, West Suffolk Hospital NHS Trust, Bury St. Edmunds, UK
H A Kamel
Affiliation:
Department of Otorhinolaryngology - Head and Neck Surgery, West Suffolk Hospital NHS Trust, Bury St. Edmunds, UK
F F Fahmy
Affiliation:
Department of Otorhinolaryngology - Head and Neck Surgery, West Suffolk Hospital NHS Trust, Bury St. Edmunds, UK
*
Address for correspondence: Mr M Sayles, Department of Otorhinolaryngology - Head and Neck Surgery, West Suffolk Hospital NHS Trust, Hardwick Lane, Bury St. Edmunds IP33 2QZ, UK E-mail: sayles.m@gmail.com

Abstract

Objectives:

To describe the clinical features of external auditory canal cholesteatoma, and to assess the outcome following bony meatoplasty with tragal cartilage and perichondrium graft repair.

Methods:

A retrospective review was carried out, comprising all patients with external auditory canal cholesteatoma who presented between January 2007 and December 2011. Patients underwent pre-operative audiometry and computed tomography imaging of the temporal bones, before undergoing bony meatoplasty via a postauricular incision. Pre- and post-operative comparisons were made of patients' otological symptoms and the otoscopic appearance of the external ear canal.

Results and conclusion:

Eight patients were included in the analyses. The median age of patients was 46.5 years (range 14–68 years), with a male to female ratio of 1:1. The median length of follow up was 16 months. The most common presenting features were unilateral otalgia and purulent otorrhoea. All patients had relatively advanced disease at presentation, with erosion of the temporal bone. All patients underwent bony meatoplasty via a postauricular approach to eradicate the disease. Bony meatoplasty was successful in the definitive management of external ear canal cholesteatoma.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Anthony, PF, Anthony, WP. Surgical treatment of external auditory canal cholesteatoma. Laryngoscope 1982;92:70–5CrossRefGoogle ScholarPubMed
2Owen, HH, Rosborg, J, Gaihede, M. Cholesteatoma of the external ear canal: etiological factors, symptoms and clinical findings in a series of 48 cases. BMC Ear Nose Throat Disord 2006;6:16CrossRefGoogle Scholar
3Kemppainen, HO, Puhakka, HJ, Laippala, PJ, Sipila, MM, Manninen, MP, Karma, PH. Epidemiology and aetiology of middle ear cholesteatoma. Acta Otolaryngol 1999;119:568–72Google ScholarPubMed
4Dubach, P, Hausler, R. External auditory canal cholesteatoma: reassessment of and amendments to its categorization, pathogenesis, and treatment in 34 patients. Otol Neurotol 2008;29:941–8CrossRefGoogle ScholarPubMed
5Dubach, P, Mantokoudis, G, Caversaccio, M. Ear canal cholesteatoma: meta-analysis of clinical characteristics with update on classification, staging and treatment. Curr Opin Otolaryngol Head Neck Surg 2010;18:369–76CrossRefGoogle ScholarPubMed
6Makino, K, Amatsu, M. Epithelial migration on the tympanic membrane and external canal. Arch Otorhinolaryngol 1986;243:3942CrossRefGoogle ScholarPubMed
7Heilbrun, ME, Salzman, KL, Glastonbury, CM, Harnsberger, HR, Kennedy, RJ, Shelton, C. External auditory canal cholesteatoma: clinical and imaging spectrum. AJNR Am J Neuroradiol 2003;24:751–6Google ScholarPubMed
8Naim, R, Linthicum, F Jr, Shen, T, Bran, G, Hormann, K. Classification of the external auditory canal cholesteatoma. Laryngoscope 2005;115:455–60CrossRefGoogle ScholarPubMed
9Bonding, P, Ravn, T. Primary cholesteatoma of the external auditory canal: is the epithelial migration defective? Otol Neurotol 2008;29:334–8CrossRefGoogle ScholarPubMed
10Hickey, SA, Scott, GA, Traub, P. Defects of the first branchial cleft. J Laryngol Otol 1994;108:240–3CrossRefGoogle ScholarPubMed
11Belcadhi, M, Chahed, H, Mani, R, Bouzouita, K. Therapeutic approaches to complicated cholesteatoma of the external auditory canal: a case of associated facial paresis. Ear Nose Throat J 2010;89:E1–6CrossRefGoogle ScholarPubMed
12Cheng, YF, Shiao, AS, Lien, CF. Pediatric external canal cholesteatoma with extensive invasion into the mastoid cavity. Int J Pediatr Otorhinolaryngol 2005;69:561–6CrossRefGoogle ScholarPubMed
13Darr, EA, Linstrom, CJ. Conservative management of advanced external auditory canal cholesteatoma. Otolaryngol Head Neck Surg 2010;142:278–80CrossRefGoogle ScholarPubMed
14Lu, W, Li, S, Qin, Z. Imaging features and surgical approach of external auditory canal cholesteatoma [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007;21:741–3Google ScholarPubMed
15Martin, DW, Selesnick, SH, Parisier, SC. External auditory canal cholesteatoma with erosion into the mastoid. Otolaryngol Head Neck Surg 1999;121:298300CrossRefGoogle ScholarPubMed
16Vrabec, JT, Chaljub, G. External canal cholesteatoma. Am J Otol 2000;21:608–14Google ScholarPubMed
17Zanini, FD, Ameno, ES, Magaldi, SO, Lamar, RA. Cholesteatoma of external auditory canal: a case report. Braz J Otorhinolaryngol 2005;71:91–3CrossRefGoogle ScholarPubMed
18Garin, P, Degols, JC, Delos, M. External auditory canal cholesteatoma. Arch Otolaryngol Head Neck Surg 1997;123:62–5CrossRefGoogle ScholarPubMed
19Shin, SH, Shim, JH, Lee, HK. Classification of external auditory canal cholesteatoma by computed tomography. Clin Exp Otorhinolaryngol 2010;3:24–6CrossRefGoogle ScholarPubMed
20Piepergerdes, MC, Kramer, BM, Behnke, EE. Keratosis obturans and external auditory canal cholesteatoma. Laryngoscope 1980;90:383–91CrossRefGoogle ScholarPubMed