Abstract：Objective To study the therapeutic principle and prognosis of external acoustic meatus cholesteatoma of different phases according to Holt standard. Methods A retrospective study was carried out on 18 patients with external acoustic meatus cholesteatoma during the recent five years. The selected subjects included 12 cases of phase Ⅱ patients treated by expansion of the external auditory canal opening and formation of the cavity of auricular concha, and 6 cases of phase Ⅲ patients treated by mastoidotympanectomy combined with the formation of the cavity of auricular concha. Their pathological tissues in the antrum mastoideum and mastoid air cells were removed to ensure smooth auris media. All the phase Ⅲ patrents were implanted with 2 cm×3 cm acellular dermal matrix in the mastoid cavity to accelerate epithelial repair. Results In the 18 patients, iodoform gauze was removed from their external auditory canals and conventional change of dressings was made. After two weeks of treatment，all the patients were able to keep their ears dry without suffering from any stenosis of the external auditory canal or infection by mycetes. Conclusions During the diagnosis and treatment of external acoustic meatus cholesteatoma, a suitable method should be chosen according to the scope of pathological change. When treating patients with phase Ⅱ and Ⅲ external acoustic meatus cholesteatoma, we should remove the cholesteatoma epithelium and place the acellular dermal matrix to obtain the optimal effect.
