CASE HISTORY / CLINIC:
Patient with purulent otorrhea and impaired hearing in the left ear for months now. Occasional slight pains on the left resembling otalgia.


FINDINGS:
Soft tissue opacity in the right epitympanum and bony erosion of the right inner ear (above).
Soft tissue shadow (no erosion of auditory ossicles) also demonstrated in the left mesotympanum (middle image). The coronal reconstruction image (below) demonstrates erosion of the tegmen tympani as well as the cholesteatoma in the meso- and epitympanum (lower picture).


DIAGNOSIS:
Cholesteatoma

DIFFERENTIAL DIAGNOSIS:
Chronic inflammation of the middle ear (chronic otitis media)



Web resources:

1) MedizInfo
2) AWMF
3) Unister
4) TopPharm
5) AHC-Consilium
6) Amersham Health