Two-handed endoscopic lateral temporal bone resection for squamous cell carcinoma of external auditory canal

A woman in her 20s presented with a 3-month history of progressive right-sided otalgia. Otoendoscopic examination revealed a greyish mass occluding more than 75% of the external auditory canal. Biopsy confirmed well-differentiated squamous cell carcinoma. High-resolution CT demonstrated cortical erosions of the anterior and posterior bony external auditory canal with mastoid involvement. The patient underwent two-handed endoscopic lateral temporal bone resection using the Justtach ASM2 endoscope holder, combined with superficial parotidectomy and selective neck dissection. Histopathological examination confirmed complete excision with negative margins. The patient received adjuvant chemoradiation therapy and remains disease-free at follow-up. This case demonstrates the technical feasibility of a two-handed endoscopic approach for temporal bone malignancy resection, though larger studies are needed to establish its efficacy compared with conventional microscopic techniques.