gms | German Medical Science

An acquired stenosis of the external ear canal is mostly caused by exostosis and inflammatory processes. Rarely malignomas are seen. We present two cases of single side stenosis of the external ear canal. Both presented with ground glass structured tumor mass in CT which is typically seen in fibrous dysplasia. The patients received a reconstruction of the ear canal. In one case a cholesteatoma was found behind the stenosis, which was not clearly seen in the preoperative CT. The histology of the second patient showed an intraosseous meningioma.

Conclusion: A fibrous dysplasia involving the temporal bone is unusual. Mostly the external ear canal is affected, whereat a cholesteatoma develops in 40–60 % behind the stenosis. Currently a lot of patients do not receive surgery early enough so that cholesteatomas are discovered late. An intraosseous meningioma of the external ear canal is extremely rare. Clinical presentation as well as CT images can be very similar to the fibrous dysplasia. A reliable differentiation is only given by histology. Hence, an acquired stenosis of the external ear canal should always be reconstructed to exclude a cholesteatoma, allow an easy management of the ear canal, improve the hearing and ensure a reliable differentiation of the process causing the stenosis. In addition there shall be a frequent ontological control postoperative to manage an optimal care and prevent a restenosis.