A Case of Congenital Cholesteatoma within the Tympanic Membrane that Recovered through Epithelization of the Remaining Matrix

Abstract

Congenital cholesteatoma within the tympanic membrane is very rare and is mainly treated with the removal of the lesion, including all of the cholesteatoma matrix and keratin debris. We report the case of a 14-month-old boy who was diagnosed as having congenital cholesteatoma in his right tympanic membrane. The patient presented with a white mass in the inferior portion of the right tympanic membrane. A computed tomography scan of the temporal bone revealed that the mass was located within the tympanic membrane but had not invaded the ossicular chain. Since the mass appeared to have increased at the time of a 1-year-follow up, we surgically removed the congenital cholesteatoma within the tympanic membrane. During the surgery, we removed the matrix under the epithelial layer of the tympanic membrane and thoroughly removed all of the keratin debris. After the surgery, the matrix on the fibrous layer of the tympanic membrane was used to cover the tympanic membrane and external auditory canal as an epithelium. To date, there have been any signs of recurrence. These findings indicate that the removal of the matrix under the epithelial layer as well as keratin debris in the cholesteatoma can lead to the complete healing of a congenital cholesteatoma within the tympanic membrane.