Vol.95 No.5 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 95 No. 5 May 2002
Two Cases of Post-Traumatic Cholesteatoma of the Mastoid Air Cells
Tadashi Kitahara, Kazumasa Kondoh, Tetsuo Morihana and Shin-ichi Okumura
(Osaka Rosai Hospital)
Yoshifumi Yamamoto
(Kansai Rosai Hospital)
Post-traumatic external ear canal cholesteatoma (EECC) is a rare condition that may present years after the original injury. We report two cases of post-traumatic EECC with a long interval between the injury and appearance of clinical symptoms.
The first case is a ten-year-old girl. She had a history of trauma around the left auricle caused by a dog bite 8 years earlier. She visited our clinic with complaints of pain, discharge, and hearing loss in the left ear. The posterior bony wall of the external ear canal (EEC) was swollen and the EEC was quite stenotic. A CT scan revealed that EECC had grown in the mastoid cavity and pushed the posterior bony wall anteriorily. The second case is a twenty-nine-year-old man. He had a history of trauma of the right temporal bone caused by a traffic accident 5 years earlier. He visited our clinic with complaints of discharge and hearing loss in the right ear. The EEC was filled with otorrhea and debris. A CT scan revealed that EECC had grown in the mastoid cavity with acute otitis externa. At surgery, we removed a cholesteatoma mass from the mastoid cavity and reconstructed the canal wall by fascia and / or cartilage in both cases. Long-term results (20-29 months) showed that hearing was improved and no recurrence was observed.
It is suggested that the trauma was the cause of the epithelial migration from the EEC to the mastoid cavity, resulting in EECC growth in the mastoid cavity, EEC stenosis, and conductive hearing loss. We would like to emphasize that patients with a history of trauma around the EEC should be followed up for EEC stenosis using an otoscope and hearing loss using audiometry to identify the generation of EECC as early as possible.
Key words : post-traumatic, cholesteatoma, external auditory meatus, canal stenosis