External ear canal cholesteatomas as a potential iatrogenic complication after cochlea implantation

Introduction Cholesteatomas are listed as a very rare complication after cochlear implant (CI) surgery, but the development especially in the outer ear canal have not been studied extensively. The purpose of this retrospective study is to describe in detail the clinical, radiological and pathological features of five patients with external ear canal cholesteatomas as a potential iatrogenic complication after CI.

Case presentation: The patients (4 female , one male) ages ranged from 11 to 67 years and had no history of cholesteatomas in the past. The clinical symptoms varied in their severity from recurrent episodes of otorrhea to retroauricular abscess due to a large cholesteatoma in the mastoid cavity extending to the promontory and an intimate contact with the electrode array. In four cases the cholesteatoma was surgically removed, leaving the CI intact with reconstruction of the posterior canal wall defect with tragal cartilage. One case acquired CI device explantation, leaving the electrode array intact intracochlear, and subtotal petrosectomy with ear canal obliteration. Discussion: 0.5 %  of patients undergoing CI present postoperative cholesteatoma as a complication of recurrent middle ear infections or as a consequence of excessive thinning of the posterior canal wall in combination with electrode array migration in the mastoid cavity. These findings underline the importance of regular follow ups with otoscopy on CI recipients with the intention of early detection of the development of cholesteatomas.

Poster-PDF A-1097.pdf

Publication History

Article published online:
13 May 2021