DOI: https://doi.org/10.36347/sasjs.2026.v12i08.001

Pages: 645-649

Background: External auditory canal cholesteatoma (EACC) is a rare osteolytic disease in which keratinising squamous epithelium accumulates within the bony external auditory canal (EAC). It is far less common than middle-ear cholesteatoma and is frequently underdiagnosed, particularly when there is no history of otologic surgery. Spontaneous and post-traumatic forms are the principal non-iatrogenic types. We report six cases managed at the Department of Otorhinolaryngology–Head and Neck Surgery, Hospital of Specialties, Rabat, and review the current literature to place the diagnostic and therapeutic issues in context. Methods: We conducted a retrospective descriptive analysis of six patients operated on for spontaneous or post-traumatic EACC between January 2017 and December 2025. Clinical presentation, otoscopic findings, imaging, surgical management and postoperative course were reviewed. Results: The commonest symptoms were otorrhoea, otalgia, aural fullness and conductive hearing loss. High-resolution CT (HRCT) consistently showed a soft-tissue opacity of the canal associated with smooth, well-defined bony erosion. Treatment consisted of complete removal of the cholesteatoma, canaloplasty or meatoplasty, and prolonged canal calibration when indicated. No major intra-operative complications occurred. One patient had a delayed recurrence during follow-up. Conclusion: Although rare, EACC is potentially destructive and calls for early recognition, HRCT confirmation, stage-adapted surgery and prolonged follow-up, since recurrence may occur years after apparently complete excision.