A 22-year-old with cholesteatoma undergoes canal wall down mastoidectomy. At the 6-month follow-up, the patient has persistent otorrhea and granulations over the eustachian tube orifice in the middle ear. Intraoperative finding of persistent cholesteatoma around the eustachian tube during initial surgery is LEAST likely to be associated with which of the following?
- A Eustachian tube dysfunction at initial presentation
- B Adenoidal hypertrophy causing functional obstruction
- C Perforation in the anteroinferior quadrant of pars tensa ✓
- D Anterior epitympanic extension of cholesteatoma
Correct answer: C. Perforation in the anteroinferior quadrant of pars tensa
Explanation
Persistent cholesteatoma around the eustachian tube is associated with anterior epitympanic extension, pre-existing eustachian tube dysfunction, and adenoidal disease causing poor middle ear ventilation. An anteroinferior perforation of the pars tensa is a feature of tubotympanic (safe) disease, which is mucosal disease without cholesteatoma and is not associated with cholesteatoma retention around the eustachian tube orifice.
Reference: Logan Turner's Diseases of the Nose, Throat and Ear, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.