THE CASE OF CONGENITAL CHOLESTEATOMA THAT SPONTANEOUSLY CURED DURING OBSERVATION

Kazuma Sugahara, Hiroaki Shimogori, Hiroshi Yamashita

Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan

Congenital cholesteatoma was first reported by Derlacki and Clemis.1 Congenital cholesteatoma is characterized by a white pearly mass behind the intact tympanic membrane. The anterosuperior quadrant of the middle-ear cleft is known to be the most frequently involved site in over 80%.

We report the case of a child with congenital cholesteatoma spontaneously cured during the observation.

A three-year-old boy was examined by his local otolaryngologist for ear wax. In the clinic, a pearl was pointed out behind the anterior-superior quadrant of an intact tympanic membrane, and the boy was referred to our hospital. He was diagnosed as cogenital cholesteatoma, and a CT-scan of the temporal bone showed a soft-tissue density mass between the malleus and anterior wall in the tympanic cavity. An erosion of ossicles was not observed and hearing level was normal with visual reinforcement audiometry. Therefore, he was followed up in our hospital.

image

Fig. 1. Disappearance of the choleateatoma in the tympanic cavity

During the follow-up period, the whitish mass behind the eardrum gradually decreased in size (Fig. 1). Three years later, at the first examination, there was no mass observed by oto-microscopy or temporal bone CT images of the middle ear. Kodama et al. reported two cases of spontaneous regression of congenital cholesteatoma in 2012.2 There could be other cases of congenital cholesteatoma cured before diagnosis. The patients with cholesteatoma are usually encouraged to have a tympanoplasty at an early stage. On the basis of our case, careful observation can be one of the treatments for congenital cholesteatoma.

References

1.Derlacki EL, Clemis JD. Congenital cholesteatoma of the middle ear and mastoid. Ann Otol Rhinol Laryngol 74:706–727, 1965

2.Kodama K, Hara M, Hasegawa M, Matsuzawa S, Shinnabe M, Kanazawa H, Yoshida N, Iino Y. Two cases of spontaneous regression of congenital cholesteatomas. Int J Pediatr Otorhinolaryngol 76:142–144, 2012

Address for correspondence: Kazuma Sugahara, MD, PhD, Department of Otolaryngology, Yamaguchi University Graduate School of Medicine, 1–1-1 Minamikogushi, Ube, Yamaguchi 755–8505, Japan. kazuma@yamaguchi-u.ac.jp

Cholesteatoma and Ear Surgery – An Update, pp. 381–382

Edited by Haruo Takahashi

2013 © Kugler Publications, Amsterdam, The Netherlands