External auditory canal cholesteatoma eacc presents uncertain etiology, representing an invasion of the squamous epithelium associated with erosion in a localized area of the external auditory canal eac. In this large case series, we aimed to define its imaging features and to determine the characteristics most important to its. Clinicians should consider congenital mastoid cholesteatoma in the differential diagnosis of patients with a mass in the external auditory canal. The exact etiology of external auditory canal cholesteatoma is unclear 4,5. External auditory canal cholesteatoma eacc is an uncommon otologic entity. Cholesteatoma of external auditory canal a rare pathology. Advancing cholesteatoma secondary to acquired atresia of. In external auditory canal cholesteatoma the significant finding is extensive erosion of the bony external auditory canal by a widemouthed sac, lined with stratified squamous keratinizing epithelium, that arises lateral to the tympanic membrane and is located in the inferior portion of the bony external canal. Cholesteatoma of the external auditory canal eac is a rare entity.
Cholesteatoma is an inflammatory lesion of the temporal bone that uncommonly involves the external auditory canal eac. In clinical practice of ear diseases, cholesteatoma occurs on the tympanummastoid segment. A cholesteatoma originating in the external auditory canal is a rare finding. It is mostly found in the middle ear and rarely in the external auditory canal 1. External auditory canal cholesteatoma eacc is a rare form of cholesteatoma first described by toynbee in 1850, corresponding to the invasion of the squamous tissue into a localized area of bony erosion of the ear canal.
Cholesteatoma of external ear clinicals, diagnosis, and. Cholesteatoma, external auditory canal, spontaneous, eacc 1. Most useful finding confirming an external ear canal cholesteatoma eecc and differentiating it from keratosis obturans is focal osteonecrosis. Acquired cholesteatoma is an inflammatory mass of the petrous temporal bone. A case of spontaneous external auditory canal cholesteatoma.
Keratosis obturans and external auditory canal cholesteatoma. It is 60 times less common than the classic middle ear cholesteatoma and occurs commonly in the elderly patients. External auditory canal cholesteatoma eacc is a rarity. Original article classification of external auditory canal. We report on a unique complication of this association in a patient suffering with recurrent neck abscesses. We report 2 cases illustrating its typical localization in the inferior part of the auditory canal and its marked osteolytic character. We also sought to identify those aspects of each disease that may lead to complications. Only 1 in 1,000 new otologic patients present with this entity, which was first described by toynbee. Several theories have been presented to try to explain the aetiology and pathogenesis of. Clinically, it is a mass of keratin that erodes the ear canal, causing necrosis and bone lysis through several mechanisms. Treatment of external auditory canal cholesteatoma under. Postradiotherapy bilateral external auditory canal. The lesion could start after a microtrauma in the canal, with consequent squamous epithelium proliferation and periostitis.
A cholesteatoma is a bonedestructive cystic mass that is lined by stratified keratinizing squamous epithelium, and this cystic mass is in an abnormal location such as the middle ear, the petrous apex or the external auditory canal. Classification of the external auditory canal cholesteatoma. Cholesteatoma develops in a setting of chronic middleear infection and a poorly pneumatized mastoid. External auditory canal cholesteatoma semantic scholar. External auditory canal cholesteatoma presents as otorrhea with a chronic, dull pain secondary to an invasion of squamous tissue into a localized area of periosteitis in the canal wall.
External auditory canal cholesteatomamedigoohealth. External auditory canal cholesteatoma eacc is a disease that is characterized by desquamating tissue and bone erosion. External auditory canal eac cholesteatoma eacc is a rare entity with an. Classification of external auditory canal cholesteatoma by. Spontaneous external auditory canal cholesteatoma in a young. The extension of such a cholesteatoma in the depth of the temporal bone is often larger than suggested by clinical examination. Erosion of the inferior canal wall and accumulation of keratin debris are. External auditory canal cholesteatoma jama otolaryngology. We report 2 cases illustrating its typical localization in the inferior part of th. Keratosis obturans presents as hearing loss and usually acute, severe pain secondary to the accumulation of large plugs of desquamated keratin in the ear canal. In two cases, the cholesteatoma was restricted to the external auditory canal, while in one case, it was complicated by a fistula with the lateral semicircular canal. Attic cholesteatoma involves the superior portion of the tympanic membrane. Wed like to understand how you use our websites in order to improve them. The treatment previously recommended for both of these conditions has been conservative debridement of the external canal and application of topical medication.
Pdf external ear canal cholesteatoma eecc is a rare otologic entity. Classification of external auditory canal cholesteatoma by computed tomography article pdf available in clinical and experimental otorhinolaryngology 31. Osteoma with cholesteatoma of the external auditory canal. Keratosis obturans would be the main differential diagnosis. External auditory canal cholesteatoma juniper publishers. Spontaneous cholesteatoma of the external auditory canal. A polyp of granulation tissue situated within the external auditory canal figure 6b. Postinflammatory medial canal fibrosis is a distinct entity characterized by the formation of fibrous tissue in the medial bone external auditory meatus. Patients underwent preoperative audiometry and computed tomography imaging of the temporal bones, before undergoing bony meatoplasty via a postauricular incision. Perforation of the membrana flaccida or of the posterior margin of the pars tensa should arouse suspicion of this lesion.
A case of external auditory canal osteoma complicated with. Congenital mastoid cholesteatoma presenting as a mass. The external auditory canal cholesteatoma eacc is a rare disease in the field of otolaryngology. External auditory canal cholesteatoma is uncommon and is estimated to occur in about 0. Although there have been numerous case reports, there are only few systematic analyses of case series, and the pathogenesis of idiopathic eacc remains enigmatic. Through inflammation and associated infection, it can cause a conductive hearing loss. In response to infection the stratified squamous epithelium from the external auditory canal extends through the perforation. The external auditory canal is an uncommon location for a cholesteatoma 1.
Persistent otorrhea was present in the patient and the diagnosis was established through noticing a soft tissue mass eroding external auditory canal anterior wall in temporal bone tomography as well as the otoscopic findings. The predominant findings are erosion of the bony structure of the external auditory canal and accumulation of keratin debris. Other terms for this lesion are acquired medial canal fibrosis, postinflammatory acquired atresia of the eac, and postinflammatory medial meatal fibrosis 17 19. In 18502,4, toynbee was the first author describing that cholesteatoma originates from the external auditory canal. Microscopic examination of the ear after meticulous removal of wax, especially in elderly patients, is useful in detecting eaccs. External auditory canal cholesteatoma eacc is a rare entity. It rarely originates from the external auditory canal eac, whose incidence is about 0. We present a case of this disease in a 40yearold patient. A cholesteatoma is a bonedestructive cystic mass that is lined by stratified keratinizing squamous epithelium, and this cystic mass is in an. Another possibility is the loss of the skin migration property, which causes retainment of desquamated cells. When they occur lateral to the tympanic membrane, they are referred to as external auditory canal cholesteatomas. Microangiopathy has a leading role in the aetiology. External auditory canal cholesteatoma eacc is a rare condition with an estimated incidence of 1.
Cholesteatomas of the external canal are usually unilateral and have associated symptoms of otalgia and otorrhea. The aim of this article is to classify eacc by different histopathologic and clinical findings of patients presenting to the department of otolaryngology at the university. Pdf cholesteatoma is an inflammatory lesion of the temporal bone that uncommonly involves the external auditory canal eac. External auditory canal eac cholesteatoma eacc is a rare entity with an estimated occurrence of one in new patients at otolaryngology clinics 1. We discuss an extensive primary eacc with an aural polyp in a male which was managed by modified radical mastoidectomy. External auditory canal cholesteatoma taipei medical. All cases of ear canal cholesteatoma treated by the author were re. Keratosis obturans and external auditory canal cholesteatoma eacc have previously been considered to represent the same disease process. Cholesteatoma is a common occurrence in the middle ear. Osteoma and cholesteatoma of the external auditory canal is a rare clinical finding, presenting specific challenges in patients suffering from this dual pathology of the ear. Cholesteatoma of the external auditory canal is very uncommon, as it is seen in only 0. We report the first case of our department of cholesteatoma of the eac.
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