BACKGROUND: Hemangiomas are relatively common in the head and neck but rarely involve the external auditory canal (EAC). Surgical approaches for EAC hemangiomas vary, and optimal surgical management remains unclear.

CASE REPORT: We present 2 cases of hemangioma involving the EAC. Case 1 involved a 68-year-old man who presented with a sensation of fullness in the left ear. Case 2 involved a 62-year-old woman who presented with right-ear fullness, hearing loss, and persistent tinnitus. Preoperative assessment included otologic examination, computed tomography, magnetic resonance imaging, and corresponding auditory evaluations. Imaging across both cases consistently revealed well-defined soft-tissue masses confined to the EAC, accompanied by localized bony irregularities but preserving the middle ear structures. Both patients underwent complete trans-canal excision with concurrent skin flap reconstruction. Histopathological analysis of the excised specimens confirmed the diagnosis of cavernous hemangioma in each case. At 1-year follow-up, both patients achieved full symptom resolution, intact canal anatomy, and no recurrence.

CONCLUSIONS: In our 2 cases, trans-canal resection combined with local flap reconstruction served as a practical approach for EAC cavernous hemangiomas, resulting in symptom resolution and preservation of canal integrity at the 1-year follow-up.

Keywords: Hemangioma, Cavernous, Otologic Surgical Procedures, Ear Canal, Surgical Flaps, Case Reports