A case of cholesteatoma associated with traumatic ear canal stenosis discovered 50 years after injury

Abstract

Acquired ear canal stenosis can be caused by trauma, inflammation, postoperative scar formation, or tumors. There is a risk of cholesteatoma formation because of keratinized deposits in the closed space, with a reduction in quality of life because of conductive hearing loss. A cholesteatoma that has grown in a closed external auditory canal is difficult to find because of its location and the original hearing loss because of ear canal stenosis. Regarding imaging for cholesteatoma, CT absorption values are nonspecific, but MRIs are said to be effective. In an MRI, diffusion-weighted images are useful for distinguishing cholesteatoma. In surgery for ear canal stenosis, it is important to adopt strategies that will prevent post-operative restenosis and re-closure. If a cholesteatoma is also present, besides excising it, the ear canal should be enlarged. It is also important to follow-up patients with traumatic ear canal stenosis. We present a case of cholesteatoma associated with traumatic ear canal stenosis discovered 50 years after injury. Here, the cholesteatoma was diagnosed by MRI, and the external ear canal was enlarged during surgery. No postoperative recurrence was observed during follow-up.

Keywords

• Ear canal stenosis
• Cholesteatoma
• MRI
• Diffusion-weighted images