Abstract:ObjectiveTo investigate the clinical features of traumatic cholesteatoma of auditory canal so as to avoid misdiagnosis.MethodsClinical data of 11 patients with external auditory canal cholesteatoma after trauma were analyzed retrospectively. The clinical features were analyzed from the aspects of history, endoscopy, auditory function, computerized tomography (CT) scan of temporal bone and surgical findings.ResultsAll the patients had trauma history of head and skull including temporal bone fracture caused by traffic accident in 7 cases and by blunt trauma in construction field in 3, as well as dog bite in one. Hearing loss was the main symptom accompanied with various degrees of ear stuffy, otorrhea, earache, tinnitus, and so on. The duration from trauma to treatment ranged from 3 months to 4 years. Pure tone audiometry showed conductive hearing loss of the affected ear. The mean airconducted hearing threshold of 0.5~4 kHz was (42.10 ±3.50) dBHL. 3, 6, 9 and 12 months after treatment, their average pure tone hearing thresholds were lower than those before treatment respectively, and the differences were statistically significant (all P﹤0.05). Preoperative CT scan of the temporal bone revealed increased density shadows of external auditory canal in all the cases, and increased density in attic, tympanic antrum as well as mastoid area in 6 cases. All patients got cured by surgical removal of lesions for maintenance of adequate drainage. Postoperative followup for 3 months to 1 year showed no recurrence.ConclusionsIt is necessary to guard against the occurrence of external auditory canal cholesteatoma in patients with gradual hearing loss of unknown reasons after trauma. Except for CSF otorrhea, it is suggested that the lacerated external auditory canal should be tamped with iodoform gauze and observed regularly to prevent and cure scar stenosis.
