Masses and disease entities of the external auditory canal: Radiological and clinical correlation (original) (raw)

Imaging diagnosis of benign lesions of the external auditory canal

Acta Otorrinolaringologica Espanola, 2012

Introduction and objectives: Benign lesions of the external auditory canal (EAC) are an infrequent cause of temporal bone CT scan requests. We are not usually well-versed in the different pathologies located in the EAC, perhaps because it is ''only'' a conduit and the relevant anatomical structures are located in the middle and inner ear.

External Auditory Canal Cholesteatoma: Clinical and Radiological Features

International Archives of Otorhinolaryngology, 2021

Introduction External auditory canal cholesteatoma (EACC) is often misdiagnosed. Objectives To outline the clinical presentation of EACC, and to describe its radiological findings on high-resolution computed tomography (HRCT) of the temporal bone. Methods The clinical records of all patients diagnosed with EACC from April 2017 to March 2020 in a tertiary care center were retrospectively reviewed. The clinical presentation, the findings on the HRCT of the temporal bone, and the treatment provided were analyzed. Results A total of 9 patients, 7 males and 2 females, with a mean age of 30 years, were diagnosed with primary EACC. Six patients presented with otorrhoea, three, with otalgia, three. with hearing loss, and one with facial palsy. Some patients had multiple symptoms. The most common findings on otomicroscopy were destruction of the posterior and inferior canal walls, with cholesteatoma and intact tympanic membrane (six patients). Two patients had aural polyp, and one had a narr...

An unusual presentation of the external auditory canal mass

The Egyptian Journal of Otolaryngology

Background External auditory canal (EAC) masses can arise secondary to a multitude of ear pathologies like congenital, inflammatory, infective, or malignancy. The most common causes of external auditory canal masses are due to otitis media—squamous and mucosal types, tubercular otitis media, malignant otitis externa, and benign tumors like osteomas, exostosis, pleomorphic adenoma, tumors from the ceruminous and sebaceous glands; and malignant tumors like squamous cell carcinoma and rhabdomyosarcoma. The management of an external auditory canal mass will vary in each case, depending upon the underlying pathology and the extent of the involvement of the surrounding structures. Case presentation In our case report, we report a neglected foreign body in the external auditory canal that presented as an EAC mass and its management. Conclusion Hence, we suggest that we need to consider an underlying neglected foreign body as a cause, whenever masses of EAC do not respond to appropriate med...

External auditory canal cholesteatoma: clinical and imaging spectrum

AJNR. American journal of neuroradiology, 2003

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. 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. 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...

Extended External Auditory Canal Cholesteatoma: Case Report and Literature Review

Journal of Head Neck & Spine Surgery, 2018

Introduction: External auditory canal cholesteatoma (EACC) is a rare disease that manifests with unilateral insidious chronic pain and otorrhea. Its evolution is slow and not very symptomatic, and its diagnosis may be delayed. Hearing is usually preserved. Computed tomography (CT) is recommended for all patients. Treatment may be clinical or surgical. Case report: Female, 69 years old, with complaint of hypoacusis and right otorrhea 10 months ago. Otoscopy of the right ear with epidermal debris in the external auditory canal and intact tympanic membrane. Tonal audiometry showed moderate right mixed loss. Temporal bone CT with expansive formation with soft tissue density with insinuation to the external auditory canal on the right. MRI with lesion presenting hypersignal at T2 and in the diffusion sequence, in close contact with the sigmoid sinus. The patient underwent open mastoidectomy. During the intraoperative period, facial nerve, sigmoid sinus, jugular bulb, posterior and middle fossa meningeal exposures were observed. Patient progressed well, without facial paralysis or recurrence of the disease. Discussion: This work calls attention to a case of EACC with extensive invasion of the mastoid at the diagnosis. The diagnosis of the lesion was clinical. CT and MRI aided in the differential diagnosis. EACC, due to its insidious nature and anatomical correlation with noble structures, should always be remembered in the differential diagnosis of external auditory canal lesions.

Case series on external auditory canal cholesteatoma: an entity often misdiagnosed

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020

External auditory canal cholesteatoma (EACC) is a rare disease. EACC presents with chronic dull aching pain with normal hearing. It is diagnosed by clinical examination and radiological investigation. Due to its rarity it is important to differentiate it from other external ear conditions. We prospectively analysed four cases of cholesteatoma of the external auditory canal in a period of 18 months. All of our patients underwent surgery. In three cases, the cholesteatoma was restricted to the external auditory canal, while in one case it was extending into the antrum. A proper clinical examination with radiological investigations will be helpful in the diagnosis and for proper management of the disease.

External Auditory Canal Cholesteatoma - A Rare Disease

Acta Scientific Otolaryngology, 2020

Cholesteatomas of external auditory canal are a form of invasive keratitis characterised by accumulation of desquamated debris in the wall of canal. External ear canal cholesteatoma is a rare condition with an estimated incidence of 1.2 in 1,000. 63-year female presented to us with complaints of left ear pain and left ear discharge. Otoscopy was normal. Pure tone audiometry showed mild mixed hearing loss in left ear. Preoperative CT scan was done. It shows the defect in external auditory canal. Canal wall down mastoidectomy with type 3 tympanoplasty was performed. Cholesteatoma sac was seen and was removed completely. Histopathology confirmed diagnosis of cholesteatoma. Primary auditory canal cholesteatoma is the invasion of squamous tissue from ear into localised area of bony erosion. The aetiology is uncertain, but in some of the series primary auditory canal cholesteatoma is post-traumatic or postsurgical. Diagnosis is confirmed on CT scan. External canal cholesteatoma is a rare condition and it poses challenge in diagnosis as it can be missed easily.

Spontaneous External Auditory Canal Cholesteatoma: Case Series and Review of Literature

Indian Journal of Otolaryngology and Head & Neck Surgery

External auditory canal cholesteatoma is a rare disease. Main symptoms of this entity are ear discharge and dull chronic ear pain and significant findings are bony erosion of the external canal with keratin debris accumulation. Inadequate diagnosis and delay in the treatment of this condition can leads to serious complications. We are presenting our experience of eight patients of spontaneous EACC treated by surgical management. As the spontaneous EACC is a rare condition, the aim of the study is to share the experience of diagnosis and management of spontaneous EACC.

Morphometry of the external auditory canal: Radiological study

Journal of Surgery and Medicine, 2020

Aim: Morphometry of the external auditory canal was not previously studied among the normal population in the literature. In this study we aimed to indicate normal values and age, gender, and side related changes of the external auditory canal of healthy individuals. Methods: Computed Tomography (CT) images of 379 patients were evaluated in this cross-sectional study. Two diameters at three points were measured on sagittal images for each side: First point was at the level of the tympanic membrane where chorda tympani leaves the bony canal. The height (1a) and width (1b) were measured from the ground where the cylindrical view of EAC was most prominent. The second point was at isthmus level, where height (2a) and width (2b) were measured. The third point was the most lateral site of external auditory canal (EAC) at the level of the tympanomastoid suture where height (3a) and width (3b) were measured. Age, gender, and side related changes for each measurement were statistically analyzed. Results: The diameter of each point in each direction was similar between the left and right sides. The median diameter of left 1a was 9.4 mm in males and 9.2 mm in females, which was significantly different. The "a" diameter of each point was higher in males than females for both sides. There was no significant difference between males and females in terms of b diameters. Diameter 1b was higher on the left side compared to the right side for females, while left-right side comparisons for other measurements were similar. None of the diameters differed between the left and right sides for males. Conclusion: Normal measurements of EAC diameters and its age, sex and side related changes are important for surgeons, radiologists, and anatomists. Proper evaluation of EAC is critical for transcanal endoscopic ear surgery and early diagnosis of a pathology impairing the anatomy of EAC on radiologic images.