Introduction. Etiopathogenetically, there are two types of chollesteatomas:
congenital, and acquired. Numerous theories in the literature try to explain
the nature of the disease, however, the question about cholesteatomas remain
still unanswered. The aim of the study was to present a case of external ear
canal cholesteatoma (EEC) developed following microsurgery (ventilation tube
insertion and mastoidectomy), as well as to point ant possible mechanisms if
its development. Case report. A 16-yearold boy presented a 4-month sense of
fullness in the ear and otalgia on the left side. A year before,
mastoidectomy and posterior atticotomy were performed with ventilation tube
placement due to acute purulent mastoiditis. Diagnosis was based on otoscopy
examination, audiology and computed tomography (CT) findings. CT showed an
obliterative soft-tissue mass completely filled the external ear canal with
associated erosion of subjacent the bone. There were squamous epithelial
links between the canal cholesteatoma and lateral tympanic membrane surface.
They originated from the margins of tympanic membrane incision made for a
ventilation tube (VT) insertion. The position of VT was good as well as the
aeration of the middle ear cavity. The tympanic membrane was intact and of
normal appearance without middle ear extension or mastoid involvement of
cholesteatoma. Cholesteatoma and ventilation tube were both removed. The
patient recovered without complications and shortly audiology revealed
hearing improving. Follow-up 2 years later, however, showed no signs of the
disease. Conclusion. There could be more than one potential delicate
mechanism of developing EEC in the ear with VT insertion and mastoidectomy.
It is necessary to perform routine otologic surveillance in all patients with
tubes. Affected ear CT scan is very helpful in showing the extent of
cholesteatoma and bony defects, which could not be assessed by otoscopic
examination alone.
External ear canal cholesteatoma after ventilation tube insertion and mastoidectomy