Early-stage external auditory canal carcinomas, classified as T1 and T2 under the modified Pittsburgh classification, are typically managed through lateral temporal bone resection (LTBR). LTBR involves the en bloc removal of both the cartilaginous and bony portions of the external auditory canal, including the tympanic membrane and malleus. This procedure integrates essential middle ear techniques, such as mastoidectomy, access to epitympanic and protympanic spaces, posterior tympanotomy, incudostapedial joint separation, and facial nerve identification. For T1 and T2 cases, LTBR alone can achieve a cure without adjunct radiotherapy or chemotherapy, offering substantial patient benefits when conducted by experienced otological surgeons. Although certain elements can be handled by less experienced surgeons, aspects like managing the mandibular fossa and the deep anterior-inferior ear canal require advanced expertise. Various approaches for defect obliteration post-resection have also been documented. This study discusses the indications and technical recommendations for performing LTBR.

We report ten cases of patients with eosinophilic otitis media (EOM) who were treated with a biologic agent (omalizumab, benralizumab, mepolizumab, or dupilumab) for comorbid bronchial asthma or eosinophilic sinusitis (ECRS) between 2013 and 2021. The biologic was administered along with existing therapy, and the patients were followed-up for at least 12 months. Two patients were started on omalizumab, two on benralizumab, five on mepolizumab, and one on dupilumab. In patients with suspected allergy to their prescribed biologic, or in those with insufficient asthma or ECRS control, the biologic was switched. In each of the 10 patients, EOM severity score, hearing changes, changes in oral or intratympanic steroid use, and nasal polyp score were evaluated before and after the use of the biologic. In the majority of these patients, use of the biologic improved both the EOM severity score and pure-tone hearing threshold. In one patient with chronic otitis media with granulation, granulation improved but EOM severity score changed mildly. Two patients with increased bone conduction threshold showed no improvement in hearing.

Haymann type IV without facial paralysis is rare in patients with Hunt syndrome. Some case reports describe immunocompromised hosts with Hunt syndrome accompanied by generalized herpes zoster. However, this presentation is rare in healthy adults.

We report the case of a 48-year-old woman who was hospitalized for evaluation of vertigo, vomiting, and fever. Her medical history included anxiety neurosis, autonomic nervous system disorders, and uterine fibroids. The patient denied a history of varicella infection. Pure-tone audiometry performed on the second day of hospitalization revealed mild left-sided sensorineural hearing loss. A blister appeared on the left auricle, without facial paralysis on the 4^th day, and the patient was diagnosed with Hayman type IV Hunt syndrome. On the same day, we initiated oral antiviral (valaciclovir) and oral steroid (prednisolone) therapy. Steroid infusion (hydrocortisone sodium succinate) was initiated the following day and was continued for 7 days. The blisters spread to the left side of the trunk, and the patient showed generalized herpes zoster lesions on the 6^th day. Acyclovir infusion therapy was initiated the same day and continued for 7 days. The patient was discharged on the 11^th day, and her left-sided hearing loss disappeared 3 months after disease onset. Dizziness during walking persisted for a long period of time, and she was diagnosed with persistent postural perceptual dizziness 4 months after symptom onset. She received oral paroxetine, and dizziness disappeared one year after disease onset.

In this case, based on observation of blisters on the auricular skin, we diagnosed Haymann type IV and initiated treatment promptly at a relatively early stage during the disease course. As reported by previous studies, early diagnosis and treatment initiation without missing the characteristic cutaneous findings are important for improvement of VIII^th cranial nerve symptoms.