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 on Undersurface of the Eardrum

1) The tympanic membrane (eardrum) is not normal appearing. Instead of being nearly see-through, there is a dense whitish color to this eardrum. Cholesteatoma (skin growth) is a whitish mass that may be adherent to the undersurface of the eardrum, as seen in this example.
2) Once the eardrum has been lifted, there is significant cholesteatoma within the middle ear cavity. As seen in this photo, the arrow points towards the flaky cholesteatoma in the middle ear cavity.
3) The white arrow indicates the adherent cholesteatoma to the undersurface of the eardrum. The taste nerve (chorda tympani nerve) is clearly seen running through the middle ear cavity and underneath the malleus, the first hearing bone (black arrow).
4) A closer look at the middle ear space. The eustachian tube opening into the middle ear cavity is indicated by the white arrow. The eustachian tube connects the middle ear cavity to the back of the nose. The black arrow is pointing to the solid bone that houses the inner ear hearing and balance organs.
5) The whitish skin (cholesteatoma) is clearly seen adherent to the undersurface of the eardrum. There should be no skin elements within the middle ear or on the undersurface of the eardrum.
6) The eardrum is repaired with a fascia graft (see tympanoplasty section) after the cholesteatoma is removed.

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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