Extensive external auditory canal cholesteatoma in the infratemporal area without mastoid involvement: use of a new surgical technique.

The external auditory canal (EAC) is an unusual location for a cholesteatoma. We present the cases of 2 patients with EAC cholesteatoma who experienced extensive damage that extended from the inferior EAC wall to the infratemporal area; there was no mastoid involvement. In both cases, the cholesteatomas were removed under local anesthesia and the inferior canal wall was reconstructed with a technique that involved the placement of a pedicled musculoperiosteal flap, a cartilage graft, and a full-thickness skin graft. This simple procedure preserves a normal EAC contour, middle ear space, and mastoid cavity.