Introduction: External auditory canal cholesteatoma is a rare condition. We are reporting a rare case of primary auditory canal cholesteatoma causing facial canal erosion with mastoid tip involvement and jugular vein thrombophlebitis. Case Report: We are presenting two cases 75years and 50 years female who presented to us with unilateral otorrhoea with hearing loss. Otomicroscopy revealed external canal wall cholesteatoma with intact Tympanic membrane. High resolution CT scan confirmed the findings of otomicroscopy and also revealed further extensive disease and erosion of fallopian canal and bone over jugular bulb. Both the patients were posted for mastoidectomy surgery & cholesteatoma was removed in toto without any complications. Conclusion: The rare occurrence of external auditory canal cholesteatoma makes it difficult to establish its incidence rates. However its possibility should be kept in mind while treating patients with Otorroea and presenting as otitis externa cases. High resolution CT scan is an important diagnostic tool for external canal wall choesteatoma. Prompt surgical intervention is the key to successful outcome with less morbidity and mortality in extensive external canal wall cholesteatoma.
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