Abstract
Congenital cholesteatoma is a mass of squamous epithelium located medial to an intact tympanic membrane without previous history of tympanic membrane perforation, otorrhoea or otological surgery. We described a 24 year old gentleman with a left postauricular discharging fistula for 3 years with recent history of gradual hearing loss, tinnitus and recurrent episodes of positional vertigo. Clinical examination noted left postauricular fistula opening and otoscopy showed a whitish mass medial to a bulging intact tympanic membrane. High-resolution computed tomography of temporal bone was suggestive of cholesteatoma. Left modified radical mastoidectomy was done and he recovered with resolution of symptoms.
 Bangladesh J Otorhinolaryngol; April 2021; 27(1): 96-99
Highlights
Congenital cholesteatoma (CC) is an expanding cystic mass of keratinizing squamous epithelium located medial to an intact tympanic membrane in patients without any prior history of tympanic membrane perforation, otorrhoea or otological surgery
We report a case of CC with discharging post auricular fistula as the sole complaint
Left and right ear had a type C and type A tympanometry respectively. His high-resolution computed tomography (HRCT) of temporal bone revealed soft tissue density in left middle ear cavity, mainly at mesotympanum extending to hypotympanum with erosion of ossicles and scutum, supporting the diagnosis of cholesteatoma
Summary
Introduction : Congenital cholesteatoma (CC) is an expanding cystic mass of keratinizing squamous epithelium located medial to an intact tympanic membrane in patients without any prior history of tympanic membrane perforation, otorrhoea or otological surgery. It is mainly a disease of childhood with a paucity of adult cases reported. Case Report : A 24 year old gentleman presented with history of discharging left postauricular fistula for the past 2 years.
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