[Clinical features and surgical treatment of external auditory canal cholesteatoma in 149 cases].

Objective

The aim of this study is to explore the clinical characteristics, surgical management and treatment results of type Ⅰto type Ⅳ external auditory canal cholesteatoma（EACC）. Method:One hundred and forty-nine patients（150 ears） with EACC underwent different surgical approach according to the classification of EACC and the lesion range: ① 44 ears: external auditory canal lesion resection with or without reconstruction of external auditory canal ② 23 ears: external auditory canal lesion resection with reconstruction of external auditory canal and the tympanoplasty（TypesⅠto Ⅲ）; ③ 32 ears: external auditory canal lesion resection with reconstruction of external auditory canal and modified mastoidectomy and reconstruction of the posterior wall of external auditory canal; ④ 28 ears: external auditory canal lesion resection with reconstruction of external auditory canal and tympanoplasty（Types Ⅰ to Ⅲ） and modified mastoidectomy and reconstruction of the posterior wall of external auditory canal; ⑤12 ears: canal wall down mastoidectomy （CWD） with plasty of the cavity of auricular concha; ⑥ 11 ears: epitympanum dectomy and reconstruction with tympanoplasty. Result:In the 150 ears, there were 38 ears classified as Type Ⅰ, 52 as Type Ⅱ, 58 as Type Ⅲ and 2 as Type Ⅳ based on the Shin classification. All patients were followed up for more than half a year. The postoperative outcomes were satisfactory with low rate of cholesteatoma recurrence and the hearing was improved to varying degrees.

Conclusion

Base on the variety of lesions, the surgical treatment method of choice depends on the extent of the lesion. Effective postoperative follow-up can reduce recurrence and avoid the second operation.