The authors present a series of 12 ears in 10 patients ranging from 18 to 72 years old with external auditory canal cholesteatomas (EACC) seen over an 8 year period. Males and females were equally involved. The left ear was involved 3 times as frequently as the right. No association with sinus or bronchial diseases was seen. Two cases were examined, 3 1/2 and 7 years before the development of any external auditory canal symptoms, and were normal. Two cases of bilateral involvement by EACC were reported. The clinical findings of EACC in this series are discussed. The authors describe a method of surgical treatment used in 12 ears with an average 3 year follow-up and excellent results. The technique involves the excision of the involved skin and periosteum followed by bone debridement. Fascia was used when 1. a large amount of skin had been removed, 2. mastoid air cells were exposed, 3. a soft tissue graft was used to fill a bony defect, or 4. when a portion of the tympanic membrane was sacrificed or its continuity interrupted.

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An adequate external auditory meatus is necessary to prevent accumulation of debris in cases of atresia and stenosis and to facilitate good postoperative care following tympanoplasty and mastoidectomy. A method of enlarging the meatus which has been used in almost 400 operations is presented. An endaural incision is made which is extended superiorly above the pinna. The upper half of the auricular cartilage is mobilized. In closing this incision the relationship of the superior edge of the tragus is advanced superiorly and the crus of the helix is moved inferiorly, thus opening the meatus. This method results in an adequate external meatus without the removal of conchal cartilage and eliminates the possibility of perichondritis.