Pediatric external canal cholesteatoma with extensive invasion into the mastoid cavity

Cholesteatoma in the external auditory canal (EAC) is an uncommon situation, and is especially rare in pediatric patients. We report two pediatric cases of external canal cholesteatoma with extensive invasion into mastoid cavity. Both cases had otalgia and poor hearing as the initial symptoms, and received operation according to the extent of the lesions. Since external canal cholesteatoma with extensive invasion into the mastoid cavity has the propensity to involve the vertical segment of the facial nerve, extreme care should be taken when performing any procedure in this area. Through thorough pre-operative evaluation and adequate surgical procedures, good outcomes can be achieved and hearing as well as facial nerve function can be preserved.