External auditory canal cholesteatoma – diagnosis and management

Abstract

<b><br>Introduction:</b> External auditory canal cholesteatoma is a rare disease. The incidence is estimated at 1 in 1,000 patients with ear diseases. The most common symptoms are discharge from the ear, hearing loss, ear pain or inflammation of the ear canal.</br> <b><br>Aim:</b> The aim of the study is to present the course of the disease, the diagnostic process, differentiation and treatment of patients with cholesteatoma of the external acoustic canal.</br> <b><br>Material and methods:</b> The available literature on the differentiation of lesions of the external auditory canal was analyzed and the results of treatment of 13 patients: 7 women and 6 men, aged 20–72 years old, operated on at the Department of Otolaryngology – Head and Neck Surgery, Medical University of Lublin in the years 2017–2023 due to cholesteatoma of the external auditory canal were presented.</br> <b><br>Results:</b> The main clinical features differentiating pathologies of the external auditory canal were presented. All patients reported recurrent ear discharge and 9 patients had mild or moderate pain. Additionally, 4 patients had conductive hearing loss and 1 patient suffered from facial nerve paresis. In 4 patients endaural approach was performed. In 9 patients, a postauricular approach was used, of which 2 underwent canaloplasty and 5 closed antromastoidectomy. Two patients required a canal wall down technique. No postoperative complications or cholesteatoma recurrence were observed in the study group. None of the patients required reoperation.</br> <b><br>Conclusions:</b> The differential diagnosis of lesions of the auditory canal should include diseases such as keratosis obstructiva, benign idiopathic osteonecrosis of the external auditory canal, necrotizing otitis externa, atresia of the external auditory canal, granulation otitis externa, lesions after radiotherapy of tumors of the ear and nasopharynx, and tumors of the temporal bone. External auditory canal cholesteatoma should be treated surgically. The type of surgery and the choice of surgical approach depend on the location and extent of the disease. With appropriate surgical technique, treatment effects and prognosis are good.</br>