Vascular Strip Cholesteatoma- A Case Report

Document Type: Case Report

Authors

1 Department of ENT, Kasturba Medical College, Manipal Academy of Higher Education, Madhavnagar Manipal, India.

2 Undergraduate Student, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

3 Department of Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India.

Abstract

Introduction:
The incidence of cholesteatoma occurring as a result of tympanoplasty is extremely rare. Understanding the cause and preventing its occurrence in the future is the main intention of highlighting this peculiar presentation.
 
Case Report:
A 25-year-old woman presented with progressive hearing loss and blocked sensation in the left ear of one and a half months duration. Past history revealed a history of left myringoplasty six years prior to presentation. Clinical examination of the ear revealed a smooth, soft epithelium covered bulge in the lateral one-third of the floor and posterior wall of the left external auditory canal. HRCT and MRI of the temporal bone confirmed the presence of a soft tissue density in the mastoid. Pure tone audiometry revealed conductive hearing loss. She underwent mastoid exploration, removal of sac with soft wall reconstruction.
 
Conclusion:
Proper placement of the vascular strip with the skin lining the external auditory canal with approximation of the incision margins is essential to prevent iatrogenic cholesteatoma formation. Close follow-up is essential to prevent any recurrence and diffusion weighted MRI plays a vital role in detection of recurrence.

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