A giant mastoid cholesteatoma with posterior cranial extension causing mass effect and obstructive hydrocephalus

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Cholesteatoma is a benign, keratinizing lesion with prolifertion of epithelial cells in the middle ear. Cholesteatomas are ivided into acquired and congenital (primary) subtypes. Acquired holesteatomas usually occur in the middle ear with rare extenion to the petroux apex unlike congenital cholesteatomas. These esions are postulated to be ectopic rests of embryologic epithelial issue in the petrous apex, which failed to undergo involution. As nternal desquamation occurs from the stratified squamous epitheium, keratinized debris accumulates centrally and forms a highly rganized structure. The advancing epithelium combined with host nflammatory response results in surrounding bone resorption [1]. he chronicity of this benign process may cause adjacent bone emodeling and mass effect without early clinical signs. We describe a rare case of giant mastoid cholesteatoma in an dult with consequent deleterious intracranial complications.