2023 Volume 116 Issue 8 Pages 757-764
We studied 160 ears of 147 patients who had been diagnosed as having external auditory canal cholesteatoma between 2006 and 2021 at our hospital.
The average age of the patients was 66.9 years, with the patients ranging in age from 7 to 95 years; 65% were women, and the annual number of patients increased steadily after 2014. There were significant underlying conditions in 66% of the cases. Osteoporosis (30%) was the most common, followed by diabetes mellitus (8.8%), maintenance dialysis (7.5%), and rheumatoid arthritis (5.6%). Several of the patients were using steroids or bisphosphonate drugs. Aging and menopause are known to be predisposing factors for primary osteoporosis, and each of the background factors mentioned above is thought to predispose to secondary osteoporosis. These results suggest that osteoporosis plays a major role in the formation of external auditory canal cholesteatoma. Many lesions in the cases of external auditory canal cholesteatoma were found around the lower wall of ear canal (75%). We selected conservative or surgical treatment depending on the extent of progression.
The results of this survey suggest that external auditory canal cholesteatomas are more common in women and the elderly, and that their incidence has been increasing in recent years. Since 66% of cases of external auditory canal cholesteatoma had underlying conditions and/or were taking drugs known to affect bone fragility, we believe that it is important to consider the background factors when treating patients with external auditory canal cholesteatoma.
