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Updated: Aug 9, 2025
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Intratympanic membrane cholesteatoma after traumatic tympanic membrane perforation: a case report
Junhui Jeong1, Hyun Seung Choi2
1Department of Otorhinolaryngology, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang, 10444, Korea.
Insights
Intratympanic membrane cholesteatoma, a growth on the eardrum, can be asymptomatic in children. Early surgical removal is recommended to prevent potential hearing loss and further complications.
Area of Science:
- Otolaryngology
- Pediatric Otology
- Dermatopathology
Background:
- Intratympanic membrane cholesteatoma (ITMC) is a rare condition often presenting as an incidental finding.
- Typically observed as a whitish, asymptomatic mass on the tympanic membrane in pediatric patients.
Observation:
- A 12-year-old boy presented with a whitish mass on his right tympanic membrane.
- History of traumatic tympanic membrane perforation treated with paper patch placement.
- Surgical excision revealed the mass confined to the outer epithelial layer, without middle ear invasion.
Findings:
- Histopathological diagnosis confirmed cholesteatoma.
- The ITMC was located on the outer epithelial layer of the tympanic membrane.
- The mass did not invade the middle fibrous or inner mucosal layers.
Implications:
- ITMC can grow outwards, potentially delaying symptom onset and diagnosis.
- Untreated ITMC can enlarge, leading to tympanic membrane compression and middle ear invasion.
- Surgical intervention for asymptomatic pediatric ITMC is advised to prevent hearing loss and complications.
Background:
Intratympanic membrane cholesteatoma presents as an asymptomatic, white, round mass on the tympanic membrane, and is usually detected incidentally in children.
Case Presentation:
A 12-year-old Korean boy visited our otorhinolaryngology clinic for a whitish mass on the right tympanic membrane. He had a history of traumatic tympanic membrane perforation in the right ear that had occurred 1 year prior, which had healed well with a paper patch placement. The mass was completely removed under local anesthesia during surgery with a microscope. The mass was on the outer epithelial layer of the right tympanic membrane and did not invade the middle fibrous and inner mucosal layers. Cholesteatoma was diagnosed on the basis of histopathology.
Conclusion:
Intratympanic membrane cholesteatoma may not induce symptoms or invade the middle ear because it can grow outwards into the external auditory canal. However, intratympanic membrane cholesteatoma can grow over time, and then after growth, it can compress the tympanic membrane and advance into the middle ear, which can cause symptoms such as hearing loss. Intratympanic membrane cholesteatoma in children should be carefully evaluated and followed, and surgical removal should be considered, even for asymptomatic cases, to minimize potential damage and hearing loss.
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