A 30 Y/O woman with chronic discharge from right

Doctor's Information

Name :  Noshin
Family :Shirvandehi
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :  Samira Shahhamzei

Patient's Information

Gender : Female
Age : 30

Case Section

Head & Neck Imaging

Clinical Summary

A 30 Y/O woman with chronic discharge from right ear

Images

Imaging Procedures and Findings

Axial CT shows opacified right middle ear . The ossicles are partially destroyed and medially displaced.(OC in figure 1). Right mastoid air cells are not pneumotizated. Coronal image reveals defect in tegmen tympani (TEG in figure 3).Fascial canal , lateral semicircular canal and otic capsule are unremarkable

Discussion

Cholesteatoma is an epidermoid cyst composed of desquamating stratified squamous epithelium. These cysts enlarge because of the progressive accumulation of epithelial debris within their lumen. They may be either congenital (2%) or acquired (98%). The diagnosis of a cholesteatoma is based on the detection of a soft tissue mass within the middle ear cavity, typically with associated bony erosion. The superior portion of the tympanic membrane (pars flaccida) retracts easily and is the most common site for formation of an acquired cholesteatoma. Cholesteatomas arising in this area originate within the Prussak space (superior recess of the tympanic membrane), which is located medial to the pars flaccida between the scutum and the neck of the malleus. Thus, a finding of soft tissue in prussac region with subtle erosion of the scutum and medial displacement of the ossicles is characteristic of a cholesteatoma. , CT plays an important role in determining the size of the lesion, as well as the status of the ossicles, the labyrinth, the tegmen, and the facial nerve.