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External auditory canal osteoma with coexisting canal wall cholesteatoma: a case report and review of literature.

J Med Case Rep

December 2024

Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.

Background: Though rare, benign lesions that usually do not necessitate active intervention, osteomas of the external auditory canal, can be troublesome when they start to produce mass effect and severe obstruction to the external auditory canal. Even more insidious is the rarer phenomenon of canal wall cholesteatomas, which have been known to cause significant canal erosion and if left unchecked and spontaneous destruction of the adjacent anatomical structures, including the facial nerve, temporomandibular joint, sigmoid sinus, and skull base. The occurrence of both these exceptionally uncommon findings in the same canal is an unusual finding and may point to an undetermined interplay in pathogenesis.

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Osteoid osteoma is a benign bone tumor that typically presents with nocturnal pain alleviated by nonsteroidal anti-inflammatory medications. The coexistence of osteoid osteoma with sickle cell anemia, a hereditary hemoglobinopathy characterized by vaso-occlusive crises and bone infarcts, poses diagnostic and therapeutic challenges due to overlapping clinical and radiological features. This condition primarily involves the long bones of the lower extremities, particularly the femur and tibia.

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Factors Related to Cholesteatoma Formation in External Auditory Canal Osteomas and Treatment Algorithm.

Ear Nose Throat J

July 2024

Division of Otology, Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.

Osteomas in the external auditory canal (EAC) can lead to stenosis, and impair epithelium migration and self-cleaning capability, thereby trapping keratinized epithelium and triggering the development of cholesteatoma. Our study aims to identify the risk of cholesteatoma development in patients with osteoma and proposes a stepwise approach to managing patients with EAC osteoma. The maximum diameter of the osteoma was measured in axial and coronal views on high-resolution computed tomography (HRCT).

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Article Synopsis
  • * A 3-year-old girl with OI experienced a complete tibial fracture and, after recovery, developed spontaneous pain at the fracture site where new imaging revealed OO.
  • * The case highlights the rare coexistence of OO and OI, suggesting that the combination of OI's bone fragility and a prior fracture may have contributed to a refracture in the same area.
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