Extra-aural spread of acquired cholesteatoma. A report of two unique cases.

The osteolytic effect of inflamed cholesteatoma can result in destruction of the bony confines of the middle ear and mastoid. Although extramastoid extension of cholesteatoma is possible through this mechanism, it is rarely seen by the otolaryngologist. We present two cases of extra-aural spread of cholesteatoma. One case illustrates the necessity of a full neuroradiologic examination of patients with neurologic findings and cholesteatoma prior to exploration of the middle ear and mastoid.