後頭蓋窩に進展し、小脳を圧排した巨大真珠腫の一症例

抄録

A 45-year-old man presented with complaints of right hearing loss, otorrhea, and headache. The right eardrum was perforated, and an inflammatory polyp was present in the middle ear, and the posterior wall of the external auditory canal was partially destructed. CT scan revealed a large mass measuring 60×55×55 mm in the posterior fossa.
The mass was found to be a cholesteatoma and it was subsequently removed. The eardrum and external auditory canal was reconstructed with fascia and cartilage, and the surgical defect was obliterated with adipose tissue. The postoperative course was uneventful, and to date there has been no recurrence of the chole st eato ma.
Initially, we considered that this cholesteatoma must be acquired, in view of the perforation of the eardrum. However, there was no cholesteatoma in the tympanic cavity, but the cholesteatoma destroyed mainly the mastoid air cells and extended i nt o the posterior fossa. Therefore, this was probably a case of congenital cholesteatoma.
It was difficult to decide how to reconstruct the posterior wall of the external auditory canal, however, we selected the closed method in order to minimize the risk of infection.