Case contributed by Bahman Rasuli
Diagnosis almost certain


Hearing loss on the left side.

Patient Data

Age: 40 years
Gender: Male

Total opacification of middle ear cavity, filling the epitympanic recess, facial recess, and sinus tympani, as well as round and oval window niches

Ossicular chain is displaced and shows eroded malleus and incus and ill-defined stapes

Widening of aditus ad antrum and formation of a common cavity between epitympanum and aditus

Opacified Eustachian tube

Intact tegmen tympani.

Case Discussion

The typical appearance of a cholesteatoma, with osteolysis of the ossicular chain of the middle ear.

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