Abstract
Bilateral congenital mesotympanic cholesteatoma is a very rare disease. It can present differently from ordinary congenital cholesteatoma. We report a case of bilateral congenital cholesteatoma diagnosed at age of 22 years old. She presented with bilateral intermittent ear discharge since 10 years old that worsening two weeks prior to her presentation to our clinic and associated with bilateral reduced hearing. Clinically there was intact tympanic membrane with retraction of the mesotympanic area with present of mass medial to tympanic membrane. CT scan imaging showed there was soft tissue in the bilateral middle ear cavity with intact scutum and ossicles. Patient undergone canal wall down procedure and the diagnosis of congenital mesotympanic cholesteatoma was confirmed with present of cholesteatoma sac at the posterosuperior part, as opposed to anterosuperior quadrant, where the common site for congenital cholesteatoma.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.307-310
Highlights
Mesotympanic cholesteatoma is part of a congenital cholesteatoma, defined as cholesteatoma mass behind an intact tympanic membrane without any previous history of otologic surgery and tympanic membrane perforation[1]
Congenital cholesteatoma is commonly localized at the anterosuperior part of tympanic membrane and rarely localized at the posterosuperior area
Congenital cholesteatoma is commonly diagnosed incidentally when there is present of white mass in the middle ear with intact tympanic membrane and it is missed even by otorinolaryngologist
Summary
Mesotympanic cholesteatoma is part of a congenital cholesteatoma, defined as cholesteatoma mass behind an intact tympanic membrane without any previous history of otologic surgery and tympanic membrane perforation[1]. Case report 22 years old lady presented to Otorhinolaryngology clinic for bilateral intermittent foul smelling ear discharge since 10 years ago that was self-limiting without seeking any treatment and it was worsening over the past tow months. It was associated with bilateral reduce hearing for 10 years and patient claimed it was not troubling her very much and she did not need any hearing assistance for that. Otological examination of the bilateral ears revealed normal external auditory canal and intact tympanic membrane Both tympanic membrane were inflammed with present of retracted pars tensa, granulation tissueat the posterior part of the tympanic membrane and whittish mass at posteroinferior part of tympanic membrane (figure 1). Patient was planned for another operation on the left side but patient was undecided yet even after a very well counselling given
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