DOI: 10.36347/sjmcr.2023.v11i04.023

Pages: 512-516

Introduction: “Skin in the wrong place”; cholesteatoma is a non-neoplastic lesion; hardly ever found in the external ear cavity. This affection; secondary or spontaneously, poses diagnostic and therapeutic challenges; one due to its numerous differential diagnosis lead by the absence of pathognomonic symptoms, two due to the lack of surgery strategies and thirdly for its potentially dangerous complications. Case Presentation: The present case elucidates a rare case of spontaneous External Auditory Canal cholesteatoma; (EACC) in 79 years old patient revealed by fetid otorrhea in the right ear, hearing loss, earache and peripheral facial palsy. Radiological imaging showed a massive destruction; of the posterior wall of the external auditory canal, the mastoid cells, tegmen mastoideum and the shell of the third portion of the facial nerve without any morphological or signal abnormalities of the inner ear. A canal wall-down mastoidectomy was performed due to extent of this cholesteatoma, which lead to a full recovery without any follow-up incidents. In light of this finding and to help elaborate the role of clinical examination and radiological imaging, discuss the differential diagnosis and therapeutic surgery management; thus, we report this case. Conclusion: EACC is a rare, potentially dangerous non-neoplastic lesion simulating petrous neoplastic lesion; the diagnosis and the management is multidisciplinary, requiring the coordination of ENT and radiological physician.