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Pars tensa cholesteatoma

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Chronic serous otitis media with reduced hearing.

Patient Data

Age: 80 years
Gender: Female
ct

The scutum is not eroded as is typically seen in pars flaccida (attic) acquired cholesteatoma.  In this case, the floor of the middle ear cleft contains soft tissue density material that erodes the adjacent bone but not the semicircular canals.  Ossicles are pushed up and stapes is not well seen (possibly eroded).  This inferior and posterior part of the affected drum is called the pars tensa and is thicker thus less prone to perforation.  Nonetheless, cholesteatomas can occur in this location.

ct

The previous study (12 months ago) showing thickening of the tympanic membrane and soft tissue swelling in the floor of the middle ear cleft but no bone erosion.

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