台耳醫誌

External auditory canal cholesteatoma (EACC) is a rare disease entity. Surgical management depends on the degree of involvement. Iatrogenic mastoiditis following surgery for EACC appears to be rare and is seldom described in the literature. We describe herein a case of early stage EACC complicated with posterior canal abscess and mastoiditis after surgery, due to posterior canal breakdown. The patient turned to our hospital and underwent a revised surgery for eradication of diffuse mastoiditis. Subsequently, the giant mastoid defect was reconstructed with rib cartilage. Based on this case, we further discuss the principles of EACC management, incidence and etiology for iatrogenic mastoiditis. Most importantly, to avoid a natural route via posterior canal defects for keratin or infection to invade into the mastoid cavity, postoperative aural toilet plays an integral role in the success of treatment.
(J Taiwan Otolaryngol Head Neck Surg 2021; 56:108-113)