A Case of External Auditory Canal Stenosis due to Temporal Bone Fibrous Dysplasia

Abstract

Fibrous dysplasia of the temporal bone (FDTB) is a rare clinical entity, the most common clinical manifestations of which are conductive hearing loss and secondary ear canal cholesteatoma caused by stenosis of the external auditory canal (EAC). Surgical intervention is appropriate in cases with functional deficits (such as conductive hearing loss) or complications (such as secondary cholesteatoma formation), however, postoperative re-stenosis of the EAC is observed at a high frequency. We present the case of a patient with FDTM in whom, despite canalplasty being performed four times during childhood, the lesion was slowly progressive and re-stenosis occureed 20 years after the last surgery. The female patient presented to our hospital with conductive hearing loss and canal cholesteatoma caused by stenosis of the EAC at the age of 40 years. Canal wall down tympanomastoidectomy and canalplasty were performed, and the extended ear canal was covered with normal bone paste and the temporalis fascia. Because FDTB is a slowly progressive benign bone lesion, complete resection is not necessary, however, a canal wall down approach with tympanomastoidectomy is recommended in cases in which the lesion extends into the middle ear and mastoid cavity.