Year :
2021
| Month :
February
| Volume :
15
| Issue :
2
| Page :
MD01 - MD03
Full Version
Cholesteatoma Masquerading as Cerumen
Published: February 1, 2021 | DOI: https://doi.org/10.7860/JCDR/2021/47191.14537
S Prabakaran, RB Namasivaya Navin, R Guna Keerthana, S Rajasekaran, K Priya
1. Assistant Professor, Department of Ear, Nose and Throat, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.
2. Senior Resident, Department of Ear, Nose and Throat, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.
3. Junior Resident, Department of Ear, Nose and Throat, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.
4. Professor and Head, Department of Ear, Nose and Throat, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.
5. Professor, Department of Ear, Nose and Throat, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India.
Correspondence Address :
Dr. S Prabakaran,
3/286, Pachaiyappar Street, Periyar Salai, Palavakkam, Chennai-41, Tamil Nadu, India.
E-mail: somu.prabakaran@gmail.com
Abstract
Cerumen is composed of glandular secretions and desquamated epithelial cells. It protects and lubricates the external auditory canal. Impacted cerumen causes canal occlusion and pressure over the tympanic membrane, causing ear discomfort, conductive hearing loss, itching, etc. Up to 6% of the general population are affected with impacted cerumen, which includes 10% of children, more than 30% of the elderly and people with cognitive impairment. Persistent symptoms despite resolution of impaction and patient repeatedly should raise suspicion of alternative diagnosis and prompt for further evaluation. A 20-year-old female patient came with complaints of decreased hearing and ear discharge. On otoscopic examination of left ear, impacted cerumen was seen in the attic region. On removal of wax with the aid of oto-endoscopy, attic region was found to be filled with cholesteatoma debris. On pure tone audiometry, patient had mild conductive hearing loss of 30 db and computed tomography of left temporal bone revealed ill-defined soft tissue density in the middle ear (epitympanum) with erosion of head of malleus and short process of incus. Blunting of scutum was also seen. Attic reconstruction and type III tympanoplasty was performed. On histopathological examination, the section showed keratin flakes with bacterial colonies which were consistent with cholesteatoma. In conclusion, any case of impacted cerumen should not be ignored by otorhinolaryngologist. Further evaluation with thorough examination under otomicroscope/otoendoscope has to be done which can lead to different diagnosis and treatment plan.
Keywords
Attic cholesteatoma, Atticotomy, Bony erosion, Impacted wax, Scutum, Tympanomeatal flap
DOI: 10.7860/JCDR/2021/47191.14537
Date of Submission: Oct 17, 2020
Date of Peer Review: Dec 04, 2020
Date of Acceptance: Dec 21, 2020
Date of Publishing: Feb 01, 2021
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Oct 19, 2020
• Manual Googling: Dec 21, 2020
• iThenticate Software: Jan 15, 2021 (18%)
ETYMOLOGY: Author Origin
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