A case of congenital external auditory canal atresia complicated by cholesterol granuloma

Abstract

Congenital ear canal atresia is a congenital disease that occurs in 1 in 10,000-20,000 individuals. In the present case, we encountered a case of unilateral external auditory canal atresia complicated by cholesterol granuloma. The patient was a four-year-old boy. At 4.5 years old, computed tomography showed a soft shadow of the mastoid cavity with bony destruction of the posterior cranial fossa, which led to the suspicion of cholesteatoma and referral to our department. After a close examination, he was suspected of having cholesterol granuloma or cholesteatoma with external, middle, and inner ear malformations and underwent tympanoplasty and mastoidectomy. During the surgery, a granuloma was found in the mastoid cavity and removed. A thick bony septum that appeared to be an atresia plate was removed to secure a ventilation route toward the eustachian tube. One year and nine months after surgery, computed tomography showed good aeration and no recurrence. In cases such as this one of cholesterol granuloma of the middle ear in which external auditory canalplasty is not indicated, it is important to secure a ventilation route in the direction of the eustachian tube.