Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com

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Cholesteatoma - Congenital Cases

1. A child with a whitish mass seen in the middle ear, behind the eardrum.  The eardrum is intact with no visible retraction pockets and no previous history of perforations (potential causes of cholesteatoma).  The congenital cholesteatoma (black arrow) is in front of the malleus, the first hearing bone, and is pressing up on the eardrum itself.  This disease is not caused by chronic ear infections, but occurs in individuals that are born with skin cells trapped behind an intact eardrum. The posterior, or back part, of the eardrum and middle ear appears to be free of cholesteatoma (white arrow).

2. After lifting up the eardrum, the cholesteatoma is clearly visualized.  The eardrum has been carefully lifted off of the malleus (white arrow).  The cholesteatoma (black arrow) has no attachment to the undersurface of the eardrum.  This congenital cholesteatoma was easily removed.

3. The area where the cholesteatoma sat is now free of disease (black arrowhead).  All skin elements have been removed from the middle ear cavity.  The hearing bones, or ossicles, have not been damaged by the cholesteatoma.

4. The eardrum, or tympanic membrane, is set back into place.  The eardrum was completely intact with no involvement by the cholesteatoma and no damage during the surgery.

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Dallas Ear Institute
7777 Forest Lane, Suite A-103, Dallas, TX 75230 | Phone: (972) 566-7600 | Fax: (972) 566-6560 | www.dallasear.com