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Iranian Journal of Otorhinolaryngology No.4, Vol.23, Serial No.65, Autumn-2011

161

Recurrence of Cholesteatoma Mimicking Dural Herniation

*Mohsen Rajati Haghi1, Seyyed Masood Naseri Sadr2

A 25 year old man was admitted to otorhinolaryngology department with a mass in the ear

canal. The patient had a history of tympanoplasty with mastoidectomy in another centre (for

chronic otorrhea)

2 years earlier. Details of the surgery were not available. He had no discharge during this time and he came to our hospital for routine follow-up visits. On otomicroscopy a white mass

was noticed in the superior part of the canal, the origin of which could not exactly be

localized. On palpation with a blunt instrument it proved to be soft. No otorrhea was noted in

the canal and the tympanic membrane seemed to be intact in the visible area.

The most likely diagnosis was cholesteatoma recurrence but the chief differential diagnosis to

be ruled out in such cases is meningocele and dural herniation.

An HRCT was ordered and the mass origin from attic was obvious. The intact tegmen

tympani rules out intracranial involvement. The patient was operated and a rather extensive

cholesteatoma was found and cleaned. It seems that he has had an attic cholesteatoma which

went unnoticed and consequently unmanaged in the previous surgery and tympanoplasty had

been done on the epidermal remnants in the attic.

Fig 1: Otoscopic view Fig 2: Coronal HRCT

Received date: 15 Jun 2011 Accepted date: 22 Aug 2011

1

Ear, Nose, Throat, Head and Neck Surgery Research Center, Department of otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran

2

Department of otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran

*Corresponding author:

Department of otorhinolaryngology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Email: rajatim@mums.ac.ir, Tel/Fax: +985118413492

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