PT  - JOURNAL ARTICLE
AU  - Marta E. Heilbrun
AU  - Karen L. Salzman
AU  - Christine M. Glastonbury
AU  - H. Ric Harnsberger
AU  - Richard J. Kennedy
AU  - Clough Shelton
TI  - External Auditory Canal Cholesteatoma: Clinical and Imaging Spectrum
DP  - 2003 Apr 01
TA  - American Journal of Neuroradiology
PG  - 751--756
VI  - 24
IP  - 4
4099  - http://www.ajnr.org/content/24/4/751.short
4100  - http://www.ajnr.org/content/24/4/751.full
SO  - Am. J. Neuroradiol.2003 Apr 01; 24
AB  - 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.