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External auditory canal cholesteatoma and benign necrotising otitis externa: clinical study of 95 cases in the Capital Region of Denmark

Published online by Cambridge University Press:  11 June 2018

J Hertz*
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet and Gentofte Hospital, Copenhagen, Denmark
C Siim
Affiliation:
Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet and Gentofte Hospital, Copenhagen, Denmark
*
Address for correspondence: Dr Jonas Hertz, Bernhard Bangs Alle 51A, 2. tv, 2000 Frederiksberg, Denmark E-mail: [email protected]

Abstract

Objective

To identify epidemiological and pathophysiological factors, and treatment strategies, in external auditory canal cholesteatoma and benign necrotising otitis externa.

Methods

A retrospective case study was conducted of patients suffering from external auditory canal cholesteatoma and benign necrotising otitis externa admitted to tertiary hospitals, in the Capital Region of Denmark, over a five-year period.

Results

Eighty-three patients (95 ears) with external auditory canal cholesteatoma or benign necrotising otitis externa were identified. A minimum incidence rate of 0.97 per 100 000 inhabitants per year was demonstrated. Sixty-eight per cent of cases had a history of smoking. Most lesions (74 per cent) were localised in the floor of the ear canal. Treatment time was 3.2 months for patients who had surgery and 6.0 months for those who received conservative treatment.

Conclusion

It is suggested that external auditory canal cholesteatoma and benign necrotising otitis externa are in fact the same disease, and therefore the diagnosis of external auditory canal cholesteatoma should be changed to benign necrotising otitis externa. Microangiopathy has a leading role in the aetiology. Surgery should be conducted in most cases.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr J Hertz takes responsibility for the integrity of the content of the paper

Presented at the Danish Otosurgical Company annual meeting, 13 October 2016, Nyborg, and at the Danish Otorhinolaryngology, Head and Neck Surgery Company (‘DSOHH’) annual meeting, 13 April 2018, Nyborg, Denmark.

References

1Dubach, P, Mantokoudis, G, Caversaccio, M. Ear canal cholesteatoma: meta-analysis of clinical characteristics with update on classification, staging and treatment. Curr Opin Otolaryngol Head Neck Surg 2010;18:369–76Google Scholar
2Tos, M. Manuel of Middle Ear Surgery, Volume 3. Stuttgart: Georg Thieme Verlag, 1997;205–18Google Scholar
3Tos, M. Manuel of Middle Ear Surgery, Volume 3. Stuttgart: Georg Thieme Verlag, 1997;228–33Google Scholar
4World Health Organization. ICD-10 online versions. In: http://www.who.int/classifications/icd/icdonlineversions/en/ [18 April 2018]Google Scholar
5Dubach, PH, Häusler, R. External auditory canal cholesteatoma: reassessment of and amendments to its categorization, pathogenesis, and treatment in 34 patients. Otol Neurotol 2008;29:941–8Google Scholar
6Piepergerdes, MC, Kramer, BM, Behnke, EE. Keratosis obturans and external auditory canal cholesteatoma. Laryngoscope 1980;90:383–91CrossRefGoogle ScholarPubMed
7Makino, K, Amatsu, M. Epithelial migration on the tympanic membrane and external canal. Arch Otolaryngol Head Neck Surg 1986;243:3942Google Scholar
8Bonding, P, Ravn, T. Primary cholesteatoma of the external auditory canal. Is the epithelial migration defective? Otol Neurotol 2008;29:334–8Google Scholar
10Owen, HH, Rosborg, J, Gaihede, M. Cholesteatoma of the external ear canal: etiological factors, symptoms and clinical findings in a series of 48 cases. BMC Ear Nose Throat Disord 2006;6:16Google Scholar
11Naim, R, Linthicum, F Jr, Shen, T, Bran, G, Hormann, K. Classification of the external auditory canal cholesteatoma. Laryngoscope 2005;115:455–60CrossRefGoogle ScholarPubMed
12Vrabec, JT, Chaljub, G. External canal cholesteatoma. Am J Otol 2000;21:608–14Google ScholarPubMed
13Lin, YS. Surgical results of external canal cholesteatoma. Acta Otolaryngol 2009;129:615–23Google Scholar
14Tseng, J, Citrin, DE, Waldman, M, White, DE, Rosenberg, SA, Yang, JC. Thrombotic microangiopathy in metastatic melanoma patients treated with adoptive cell therapy and total body irradiation. Cancer 2014;120:1426–32CrossRefGoogle ScholarPubMed
15Jahnke, K, Lieberum, B. Surgery of cholesteatoma of the ear canal [in German]. Laryngorhinootologie 1995;74:46–9Google Scholar
16The Danish Cancer Society. In: www.cancer.dk [17 April 2018]Google Scholar
17Shin, SH, Shim, JH, Lee, HK. Classification of external auditory canal cholesteatoma by computed tomography. Clin Exp Otorhinolaryngol 2010;3:24–6Google Scholar
18Darr, EA, Linstrom, CJ. Conservative management of advanced external auditory canal cholesteatoma. Otolaryngol Head Neck Surg 2010;142:278–80Google Scholar