Canal cholesteatoma in canal stenosis

Abstract

Introduction: We present a case of a 12-year-old girl with canal cholesteatoma (CC) with canal stenosis to discuss the clinical, radiological, and treatment options for this disease. Patient: A 12-year-old girl with the right microtia with canal stenosis, who was referred to our center, presented with the right ear discharge for the past 2 years. Otoscopic findings showed the right stenotic ear canal with no ear discharge and normal ear on the left. High-resolution computed tomography (CT) temporal bone revealed the presence of soft-tissue density in the middle ear with canal stenosis. Interventions: Modified radical mastoidectomy (MRM), meatoplasty, and tympanoplasty type V were performed. The patient was discharged well from the hospital after the operation. However, there was an evidence of recurrence at 8 months later when the patient presented with the right ear discharge. The right mastoid exploration and pinnaplasty were done, revealed the findings of cholesteatoma in antrum and middle ear cavity with abscess in the mastoid bowl. Conclusion: All patients with congenital canal stenosis should undergo a CT scan of the temporal bone at an early age to exclude CC. Hearing assessment is necessary to achieve early intervention, such as canalplasty or bone conduction hearing aid fitting.