Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Heilbrun, M. E. Articles by Shelton, C. Search for Related Content PubMed PubMed Citation Articles by Heilbrun, M. E. Articles by Shelton, C.

American Journal of Neuroradiology 24:751-756, April 2003
© 2003 American Society of Neuroradiology

HEAD AND NECK

External Auditory Canal Cholesteatoma: Clinical and Imaging Spectrum

Marta E. Heilbrun^a, Karen L. Salzman^a, Christine M. Glastonbury^a, H. Ric Harnsberger^a, Richard J. Kennedy^b and Clough Shelton^b

^a Department of Radiology, Division of Neuroradiology, University of Utah School of Medicine, Salt Lake City
^b the Department of Otolaryngology, University of Utah School of Medicine, Salt Lake City

Address reprint requests to Karen L. Salzman, Department of Radiology, Division of Neuroradiology, 1A71 University Hospital, 50 North Medical Drive, Salt Lake City, UT 84132

BACKGROUND AND PURPOSE: Cholesteatoma is an inflammatory lesion of the temporal bone that uncommonly involves 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 clinical management.

METHODS: Thirteen cases of EAC cholesteatoma (EACC) were retrospectively reviewed. Clinical data were reviewed for the history, presentation, and physical examination findings. 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. The middle ear cavity, mastoid, facial nerve canal, and tegmen tympani were evaluated for involvement.

RESULTS: Patients presented with otorrhea, otalgia, or hearing loss. Eight cases were spontaneous, and five were postsurgical or post-traumatic. CT imaging in all 13 cases showed a soft-tissue mass with adjacent bone erosion. Intramural bone fragments were identified in seven cases. This mass most often arose inferiorly (n = 8) or posteriorly (n = 8), but it was circumferential in two cases. We noted middle ear extension (n = 5), mastoid involvement (n = 4), facial canal erosion (n = 2), and tegmen tympani dehiscence (n = 1).

CONCLUSION: Temporal bone CT shows EACC as a soft-tissue mass within the EAC, with adjacent bone erosion. Bone fragments may be present within the mass. The cholesteatoma may extend into the mastoid or middle ear, or it may involve the facial nerve canal or tegmen tympani. Recognition of this entity and its possible extension is important because it may influence clinical management.