Morita S, et al. - This research incorporated a scrutiny of the clinical characteristics and therapeutic outcomes for patients with idiopathic and secondary external auditory canal cholesteatoma (EACC). Additionally, experts intended to validate the treatment strategy from the standpoint of hearing, etiology and staging. Findings recommended the selection of therapeutic modalities on the basis of the perspective of hearing as well as the extent of disease and etiology. It was noted that the early lesions could be treated conservatively. In contrast, complete surgical removal of EACC was required in the case of advanced lesions or cases refractory to conservative management.

Methods

• Researchers pursued a retrospective case series study.
• It was performed at tertiary referral center and affiliated hospitals.
• The enrollment consisted of 58 patients with idiopathic EACC and 14 patients with secondary EACC.
• As a part of the intervention, conservative management and surgery were included.
• The primary outcome constituted air conduction (AC) pure-tone averages (PTAs) and mean air-bone gaps (ABGs).

Results

• Findings did not disclose any notable variations between hearing values before and after conservative management for idiopathic EACC patients with stages I-III.
• Data pointed out that hearing abilities were preserved.
• A substantial improvement was noted in the AC PTA threshold and mean ABG from a preoperative value of 60.3 dB HL to a postoperative value of 32.4 dB HL (p=0.013), and from 34.3 to 9.5 dB HL (p < 0.001), respectively, for idiopathic EACC patients with stage IV disease treated with surgery.
• In the case of secondary EACC, a marked improvement was reported in the AC PTA threshold and mean ABG from a preoperative value of 49.5 dB HL to a postoperative value of 23.2 dB HL (p < 0.001), and from 31.4 to 6.7 dB HL (p < 0.001), respectively.