title: Surgical Treatment of External Auditory Canal Cholesteatoma - Ten Years of Clinical Experience.
abstract: OBJECTIVE
  To describe the clinical manifestations of external auditory canal (EAC) cholesteatoma and evaluate the surgical outcomes of reconstruction using an inferior pedicled soft-tissue periosteum flap.
  
  
  METHODS
  A total of 28 patients were enrolled in this retrospective study conducted at Kaohsiung Medical University Hospital in Taiwan between January 2004 and December 2013. EAC cholesteatoma was classified according to the disease extent. The surgery was performed to reconstruct a smooth contour of EAC.
  
  
  RESULTS
  The average age of the 28 patients (9 males and 19 females: 30 surgical ears) was 53.7 years. The most common clinical manifestations were unilateral otalgia (63.3%) and otorrhea (46.7%), and the most frequent locations of EAC cholesteatoma with bony invasion were the posterior-inferior (40%), inferior (30%), posterior (20%), and posterior-inferior-anterior (10%) aspects. Based on Naim's staging systems of EAC cholesteatoma, 26 ears (86.7%) were classified as stage III and 4 ears (13.3%) as stage IV. All patients received surgical management via a postauricular approach, and the average length of postoperative follow-up was 61.5 months (range 8-131 months). One patient had recurrence after surgery for 1 year 3 months.
  
  
  CONCLUSIONS
  Bony canaloplasty and obliteration with an inferior pedicled soft-tissue periosteum flap is a reliable procedure for EAC cholesteatoma.
authors.affiliation: Department of Otolaryngology, Kaohsiung Medical University Hospital, Taiwan; Department of Otolaryngology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan. hmwang@kmu.edu.tw.
authors.forename: Kuen Yao
authors.initials: KY
authors.lastname: Ho
authors.forename: Tzu Yen
authors.initials: TY
authors.lastname: Huang
authors.forename: Shih Meng
authors.initials: SM
authors.lastname: Tsai
authors.forename: Hsun Mo
authors.initials: HM
authors.lastname: Wang
authors.forename: Chen Yu
authors.initials: CY
authors.lastname: Chien
authors.forename: Ning Chia
authors.initials: NC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D004424:Ear Canal / Q000601:surgery*; D004433:Earache / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods; D019651:Plastic Surgery Procedures; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome