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


  • Priti S. Hajare Department of Otorhinolaryngology, Head and Neck Surgery, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
  • O. Padmavathy Department of Otorhinolaryngology, Head and Neck Surgery, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India



Cholesteatoma, External auditory canal cholesteatoma, High-resolution computed tomography


External auditory canal (EAC) cholesteatoma is a rare disease. EAC cholesteatoma 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.


Verma H, Dass A, Singhal SK, Gupta N.Outer auditory canal cholesteatoma. Int J Health Allied Sci. 2017;6:230-2.

Aswani Y, Varma R, Achuthan G. Spontaneous external auditory canal cholesteatoma in a young male: imaging findings and differential diagnoses. Indian J Radiol Imaging. 2016;26:237-40.

Lesser THJ. Keratosis obturans, primary auditory canal cholesteatoma and benign necrotizing otitis externa. In: Scott-Brown’s Otorhinolaryngology Head and Neck Surgery. 8th ed. CRC Press; 2018: 941-946.

Dhingra P, Pusalkar AG. Spontaneous External Auditory Canal Cholesteatoma: Case Series and Review of Literature. Indian J Otolaryngol Head Neck Surg. 2020;72:86-91.

Naim R, Linthicum F Jr, Shen T, Bran G, Hormann K. Classification of the external auditory canal cholesteatoma. Laryngoscope. 2005;115(3):455-60.

Shin SH, Shim JH, Lee HK. Classification of external auditory canal cholesteatoma by computed tomography. Clin Exp Otorhinolaryngol. 2010;3(1):24-6.

Ho KY, Huang TY, Tsai SM, Wang HM, Chien CY, Chang NC. Surgical treatment of external auditory canal cholesteatoma. J Int Adv Otol. 2017;13(1):9-13.

Sayles M, Kamel HA, Fahmy FF. Operative management of external auditory canal cholesteatoma: case series and literature review. J Laryngol Otol. 2013;127:859-66.

Bhagat S, Varshney S, Bist SS, Mishra S, Kabdwal N, Kumar R. Primary external auditory canal cholesteatoma presenting as cerebellar abscess. Indian J Otol. 2013;19:88-91.

Mahdoufi R, Tazi N, Barhmi I, Abada R, Mahtar M. Bilateral primitive cholesteatoma of external auditory canal with congenital stenosis. Int J Surg Case Rep. 2016;24:108-11.






Case Series