Acquired atresia of external auditory canal with canal cholesteatoma: a case report

Sheikh Abdul Zeeshan., Mehtab Alam and Kamlesh Chandra

Acquired secondary atresia of external auditory canal (EAC) is a rare entity in routine otolaryngology practice. The atretic canal can desquamate and trap keratin debris leading to formation of dreaded condition called canal cholesteatoma. This is also accompanied with moderate to severe conductive hearing loss. A cholesteatoma is a cystic keratin filled mass lined with stratified squamous epithelium. It is an inflammatory lesion of the middle ear and mastoid that uncommonly involves the external auditory canal (EAC). The canal cholesteatoma has bone eroding properties and might progress unhindered into middle ear and mastoid and thereby producing various complications. EAC cholesteatoma can have numerous differential diagnoses so it poses a diagnostic challenge. In this case report we have illustrated the clinical details of a 20 years old male whole presented with progressive deformity of left pinna, progressive occlusion of left ear canal and progressive decreased hearing in left ear since 4 months. Pure tone audiometry revealed conductive hearing loss of 45 dB in left ear. High resolution computed tomography (HRCT) demonstrated complete occlusion and a soft tissue density lesion filling the left external auditory canal. There was limited erosion of the canal wall with ipsilateral mastoid air cells showing good pneumatisation. The middle ear cavity was uninvolved. Thus a diagnosis of acquired atresia with cholesteatoma of external auditory canal was established and was managed accordingly.

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