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Updated: Jan 18, 2026

Endoscopic Cholesteatoma Surgery

Endoscopic Cholesteatoma Surgery

Published on: January 19, 2022

Cholesteatoma in concha-type microtia.

Nobuyuki Mitsuhashi¹, Takatoshi Yotsuyanagi², Ken Yamashita²

¹Department of Plastic and Reconstructive Surgery, Iwate Medical University, Iwate, Japan.

Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS

|January 16, 2026

Summary

Concha-type microtia with ear canal stenosis poses a risk of cholesteatoma, potentially impacting auricular reconstruction. Early detection and surgical management are crucial for successful outcomes.

Keywords:

Cholesteatoma Concha-type Congenital aural stenosis Microtia

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Area of Science:

Plastic Surgery
Otolaryngology
Congenital Malformations

Background:

Concha-type microtia and congenital aural stenosis increase the risk of external auditory canal cholesteatoma.
Cholesteatoma can lead to infection and compromise costal cartilage grafts used in auricular reconstruction.
Limited awareness among plastic surgeons highlights the need for better understanding and management strategies.

Purpose of the Study:

To review cases of cholesteatoma in patients with concha-type microtia.
To discuss optimal management strategies for cholesteatoma in this patient population.
To improve awareness and surgical planning for auricular reconstruction.

Main Methods:

Retrospective review of patients with concha-type microtia and congenital aural stenosis undergoing auricular reconstruction (January 2018 - December 2021).
Identification and analysis of patients who developed external auditory canal cholesteatoma.
Evaluation of cholesteatoma occurrence, treatment, complications, graft outcomes, and recurrence.

Main Results:

Among 83 patients with concha-type microtia, 4 (6.7%) developed cholesteatoma, particularly those with severe stenosis (<4 mm).
Cholesteatoma was diagnosed preoperatively, shortly after, or after reconstruction, with one requiring graft removal.
All patients underwent cholesteatoma excision and canalplasty; follow-up showed mild restenosis but no recurrence.

Conclusions:

Concha-type microtia with congenital aural stenosis presents a significant risk for cholesteatoma development.
Preoperative screening for cholesteatoma is essential, with excision recommended before auricular reconstruction.
Close collaboration with otolaryngologists and vigilance during and after surgery are vital to prevent complications.