Diagnosis and management of external auditory canal cholesteatoma (EAC)

Introduction: Cholesteatoma is a lesion formed from keratinized stratified squamous epithelium that occurs in the temporal bone and is often found in the middle ear. Cholesteatoma of the ear canal, commonly referred to as External Auditory Canal Cholesteatoma (EAC), involves the invasion of squamous epithelial tissue into the bone of the external auditory canal, which is locally aggressive and erodes the bone. Other terms introduced by experts include keratoma, squamous epitheliosis, cholesteatosis, epidermoid cholesteatoma, epidermoid cyst, and epidermosis. Management of external auditory canal cholesteatoma can be either conservative or surgical. Conservative treatment is indicated when the cholesteatoma and bone erosion are limited to the external auditory canal. Surgical intervention is required when there is extension to the middle ear or mastoid, the presence of complications or potential complications, persistent otorrhea not responsive to conservative therapy, or significant hearing loss.

Case Report: We report a case of a 21-year-old woman with External Auditory Canal Cholesteatoma (EAC).

Conclusion: The definitive diagnosis of cholesteatoma is made through histopathological examination revealing benign keratinized squamous cells. Extirpationf of granulation tissue and cholesteatoma via a transcanal approach was performed, involving the removal of debris and keratin through surgery. The pathological tissue was scraped until normal skin margins were achieved. Eroded bone was cleaned, and granulation tissue was removed until healthy tissue was identified to facilitate healing.