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Primary external auditory canal cholesteatoma of 301 ears: a single-center study

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Limited literature exists on primary external auditory canal (EAC) cholesteatoma (EACC). Here, we focus on the clinical features of this rare disease, especially the invasive patterns of lesion progression, through a large population study and present simple and practical staging.

Methods

In all, 276 patients (male 99; female 177; mean age 41.3 ± 21 years; ears 301) with primary EACC were retrospectively analyzed. Stage I indicated EACC without bony lesions, stage II indicated invasion confined within EAC, stage III indicated invasion beyond the EAC involving mastoid air cells or tympanic cavity, but within the temporal bone, and stage IV indicated invasion beyond the temporal bone.

Results

In all, 41, 219, 40, and 1 ear with Stage I, II, III, and IV lesions were found, respectively. Common clinical symptoms were hearing loss (237 ears, 78.7%), otalgia (221 ears, 73.4%), and otorrhea (85 ears, 28.2%). The mean air conduction and air-bone gaps were 45.4 ± 17.9 dB HL and 24.6 ± 15 dB HL, respectively. EACCs were found to invade in all directions of the EAC, with the inferior wall (224 ears, 74.4%) > posterior wall (207 ears, 68.8%) > anterior wall (186 ears, 61.8%) > superior wall (86 ears, 28.6%) invasion; multiwall invasions (207 ears) were common; however, inward invasions into the tympanic cavity were rare.

Conclusion

Primary EACCs occurred mostly in women and often unilaterally invaded multiple bony walls in the lower half of the EAC. The present staging reflects the patterns and severity of lesion progression and may be beneficial in treatment planning.

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Acknowledgements

The authors would like to express their gratitude to Yuan Zhang and Jing Yang from the Medical Case Management and Information Department of our hospital.

Funding

This study was funded by the Health Science and Technology Program Projects of Fujian Province, China (Grant number: 2020CXB044) and the Natural Science Foundation of Fujian Province, China (Grant number: 2019J01624).

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Authors and Affiliations

  1. Department of Otolaryngology, Ningde Municipal Hospital Affiliated of Ningde Normal College (Ningde Institute of Otolaryngology), Ningde, 352100, Fujian, China

    Guanwen He, Rifu Wei, Liwen Chen, Yiyun Hong, Huifeng Li, Ping Liu, Yangbin Xu & Zhongshou Zhu

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  1. Guanwen He
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  2. Rifu Wei
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Correspondence to Guanwen He or Zhongshou Zhu.

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Informed consent waived because this is a retrospective study.

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Approval IRB approval was obtained.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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He, G., Wei, R., Chen, L. et al. Primary external auditory canal cholesteatoma of 301 ears: a single-center study. Eur Arch Otorhinolaryngol 279, 1787–1794 (2022). https://doi.org/10.1007/s00405-021-06851-0

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