Abstract: Objectives To identify the clinical characteristics of and assess the therapeutic options for external auditory canal cholesteatoma(EACC). Methods The clinical data of 47 cases of external auditory canal cholesteatoma operated at our hospital from January 2015 to December 2016 were retrospectively analyzed. Results All patients underwent pre-operative audiometry, otoendoscopy, and computed tomography(CT)imaging of the temporal bones. All patients presented with an external ear canal full of yellow-white squamous material or granulation tissue. Aural fullness, otalgia, and purulent otorrhea were the commonly reported symptoms. Bony erosions were noted in 41 patients on CT. The staging according to Holt disclosed that 6 patients had stage Ⅰ EACC, 29 had stage Ⅱ, and 12 had stage Ⅲ. The six patients diagnosed as having stage Ⅰ EACC and 5 teenagers diagnosed as having stage Ⅱ EACC were treated by cholesteatectomy and/or resecting granulation tissue from the external auditory canal. The 24 adults diagnosed as having stage Ⅱ EACC were treated with combined cholesteatectomy and canaloplasty. Nine of 12 patients diagnosed as having stage III EACC were managed via modified radical mastoidectomy and/or tympanoplasty, and 3 patients were treated with radical mastoidectomy. All patients had dry ear at 2 weeks, which completely epithelialized in 3 months post-surgery. The hearing loss showed partial recovery in most patients except in the three patients who underwent radical mastoidectomy. The patients were followed up from 3 to 24 months, and no recurrence was observed. Conclusion EACC could be misdiagnosed. Bone erosion is the most important characteristic of EACC. A CT scan of the temporal bone is useful for staging and surgical planning. The surgical procedures are selected according to the disease stage, age, and hearing level. Complete removal of cholesteatoma and adequately opening the auditory canal are crucial for prevention of recurrence.

Key words: External auditory canal, Canaloplasty, Cholesteatoma