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Acquired middle ear cholesteatoma

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Left epitympanic membrane retraction on clinical examination

Patient Data

Age: 50 years
Gender: Female

Small (2-3 mm) soft tissue mass in the left space of Prussak adjacent to the neck of the malleus at the site of tympanic membrane retraction on clinical examination.  When compared with the normal right side, the tip of the scutum is minimally eroded.

Case Discussion

A small defect in the epitympanum (pars flaccida) allows skin from the external canal to grow into the middle ear at the scutum and to accumulate in the Prussak space causing erosion to the scutum tip at its junction with the tympanic membrane (and the adjacent malleus).

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