External auditory canal cholesteatoma (EACC) is a rare disease, and the pathogenesis and optimal treatment method are not yet established. From January 2018 to July 2019, we performed transcanal endoscopic ear surgery (TEES) on 6 ears with EACC. The median age of the patients was 64 years, and the site of involvement was the inferior wall in 4 ears and both the inferior and anterior walls in 2 ears. According to Naim’s classification, 4 of the affected ears were classified as Stage III and the remaining 2 were classified as Stage IV. Of the 2 Stage IV cases, the disease extended to the temporomandibular joint in 1 case, and to the temporomandibular joint, eardrum, and tympanic cavity in the other. Underlying disease with microangiopathy was noted in 66% of the cases (4/6 ears) had (myocardial infarction, n = 1; dialysis for chronic renal failure, n = 1; administration of bisphosphonate, n = 1; subarachnoid hemorrhage and hypertension, n = 1). Therefore, from the perspective of wound healing, EACC requires minimally invasive surgery. Even in cases where the temporomandibular joint capsule was exposed, the anterior wall of the external auditory canal could be visualized because the endoscope had a wide field of view. In all patients, a dry and self-cleaning external auditory canal was found to be maintained at the time of the follow-up at 12 months. Our results suggest that TEES is useful for EACC.
