Abstract External auditory canal cholesteatoma (EACC) is a rare condition characterized by aberrant keratin accumulation in the external auditory canal. Although radiation-induced EACC has been documented in postradiotherapy (RT) patients with nasopharyngeal carcinoma, its association with prior parietal radiation therapy, particularly when complicated by facial nerve palsy, remains exceptionally rare. We present a 33-year-old patient with relapsed B-cell lymphoma and a history of parietal region RT, who developed facial nerve palsy followed by EACC 6 years post-RT. Imaging demonstrated extensive temporal bone erosion, fallopian canal dehiscence and mastoid involvement while histopathology confirmed cholesteatoma without lymphomatous involvement. The latency period correlated with delayed radiation effects. Surgical management through modified radical mastoidectomy achieved disease clearance with no recurrence at follow-up. This case highlights EACC as a rare but significant late sequela of RT, underscoring the importance of vigilant long-term otologic surveillance in irradiated patients.
Yet et al. (Wed,) studied this question.
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