External auditory canal: Inferior, posterior-inferior, and anterior canal wall overhangs

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.

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Combined underwater endoscopic and microscopic surgery for external auditory canal cholesteatoma: A case report

Ear Nose & Throat Journal ◽

10.1177/01455613211064011 ◽

2021 ◽

pp. 014556132110640

Author(s):

Takashi Anzai ◽

Yusuke Takata ◽

Satoshi Hara ◽

Kenji Sonoda ◽

Katsuhisa Ikeda ◽

...

Keyword(s):

Case Report ◽

Minimally Invasive ◽

External Auditory Canal ◽

Invasive Procedure ◽

Endoscopic Ear Surgery ◽

Minimally Invasive Procedure ◽

Canal Wall ◽

Ear Surgery ◽

Microscopic Surgery ◽

External Auditory Canal Cholesteatoma

Transcanal endoscopic ear surgery is a minimally invasive procedure that allows a clear visualization of the middle ear. Recently, indications for endoscopic surgery have been expanding. We performed combined underwater endoscopic and microscopic surgery for external auditory canal cholesteatoma, the computer tomography of which indicates the possibility of cholesteatoma not only in the canal wall but also in the mastoid. The 30° endoscope and underwater technique makes the surgical view clear, and we could remove the cholesteatoma without canalplasty. To the best of our knowledge, no case of external auditory canal cholesteatoma treated with underwater endoscopic and microscopic surgery has been previously reported. This case indicates that the procedure could be a good indication for external auditory canal cholesteatoma.

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Platelet-Rich Plasma in Reconstruction of Posterior Meatal Wall after Canal Wall Down Mastoidectomy

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1602694 ◽

2017 ◽

Vol 22 (02) ◽

pp. 103-107 ◽

Cited By ~ 1

Author(s):

Mohammad Elbary ◽

Wail Nasr ◽

Samir Sorour

Keyword(s):

External Auditory Canal ◽

Platelet Rich Plasma ◽

Preoperative Evaluation ◽

Hot Water ◽

Surgical Reconstruction ◽

Mastoid Cavity ◽

Titanium Mesh ◽

Canal Wall ◽

Suppurative Otitis Media ◽

Canal Wall Down

Introduction Canal wall down (CWD) mastoidectomy has many drawbacks, including chronic otorrhea not responding to medications, granulations, dizziness on exposure to cold or hot water, and tendency of debris accumulation in the mastoid cavity, demanding periodic cleaning. Many of these problems can be solved by reconstruction of the posterior meatal wall (PMW). Objectives To assess the results of PMW reconstruction after CWD mastoidectomy for cholesteatoma using titanium mesh and platelet-rich plasma (PRP) mixed with bone pate. Methods This study was conducted with 20 patients that have atticoantral chronic suppurative otitis media. All cases were subjected to CWD mastoid surgery with complete elimination of the disease and reconstruction of the PMW by titanium mesh and the mixture of PRP with bone pate. All patients were exposed to a full preoperative evaluation and full postoperative assessment of the complications, the appearance of the external auditory canal contour, and the hearing gain expressed by the change of the air bone gap postoperatively. Results The PMW reconstructed by titanium mesh and the mixture of PRP with bone pate showed a smooth contour. During the follow-up of 12 to 36 months, the postoperative appearance of the external auditory canal contour was found to be smooth without hidden pouches, irregularities or stenosis in all cases. No granulation, foreign body reaction, or extrusion and/or displacement of the titanium mesh were registered. No facial palsy or recurrent cholesteatoma was reported. Conclusion The surgical reconstruction of the PMW using PRP, bone pate and titanium mesh after CWD mastoidectomy appears to be reliable without considerable complications, giving a smooth appearance to the PMW.

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