Primary acquired cholesteatoma

April 30, 2012
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Otoscopic Clinic

Cholesteatomas are believed to form as the result of poor eustachian tube function with resultant tympanic membrane retraction and a lack of normal epithelial migration.

A 40-year-old woman with a history of multiple ear infections as a child presented with right-sided hearing loss and aural pressure. Otoscopy revealed a pars flaccida retraction that contained crusted debris, as well as a white mass in the posterior mesotympanum (figure). The patient's audiogram showed a 25-dB right conductive hearing loss. Computed tomography of the temporal bone demonstrated a soft-tissue mass in the epitympanum with erosion of the scutum.

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