![]() ![]() For these reasons, the neuroradiologist may have an important role in the diagnosis and management of these lesions. The true extent of EACC may be inapparent on clinical examination. The clinical differential diagnosis covers a range of operative and nonoperative conditions, including neoplasms of the EAC and inflammatory or infective conditions such as keratosis obturans, postinflammatory medial canal fibrosis, and malignant otitis externa. Most cases are spontaneous or occur after surgery or trauma to the auditory canal, though pre-existing ear-canal stenosis or obstruction has also been reported to produce EACC ( 3). Patients with EACC typically present with otorrhea and a chronic, dull pain due to the local invasion of squamous tissue into the bony EAC ( 2). External auditory canal (EAC) cholesteatoma (EACC) is a rare entity with an estimated occurrence of one in 1000 new patients at otolaryngology clinics ( 1). Recognition of this entity and its possible extension is important because it may influence clinical management.Īcquired cholesteatoma is an inflammatory mass of the petrous temporal bone it is most commonly encountered in the middle ear cavity. The cholesteatoma may extend into the mastoid or middle ear, or it may involve the facial nerve canal or tegmen tympani. Bone fragments may be present within the mass. We noted middle ear extension (n = 5), mastoid involvement (n = 4), facial canal erosion (n = 2), and tegmen tympani dehiscence (n = 1).ĬONCLUSION: Temporal bone CT shows EACC as a soft-tissue mass within the EAC, with adjacent bone erosion. This mass most often arose inferiorly (n = 8) or posteriorly (n = 8), but it was circumferential in two cases. Intramural bone fragments were identified in seven cases. CT imaging in all 13 cases showed a soft-tissue mass with adjacent bone erosion. Eight cases were spontaneous, and five were postsurgical or post-traumatic. RESULTS: Patients presented with otorrhea, otalgia, or hearing loss. ![]() The middle ear cavity, mastoid, facial nerve canal, and tegmen tympani were evaluated for involvement. High-resolution temporal bone CT scans were examined for a soft-tissue mass in the EAC, erosion of adjacent bone, and bone fragments in the mass. Clinical data were reviewed for the history, presentation, and physical examination findings. METHODS: Thirteen cases of EAC cholesteatoma (EACC) were retrospectively reviewed. In this large case series, we aimed to define its imaging features and to determine the characteristics most important to its clinical management. BACKGROUND AND PURPOSE: Cholesteatoma is an inflammatory lesion of the temporal bone that uncommonly involves the external auditory canal (EAC). ![]()
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