PMC4364359_01
(a) High resolution CT axial image at the level of the lateral semicircular canal demonstrates a fluid filled mastoid cavity, partial erosion of incus, and an intact anterior epitympanic air cell partitioned by the cog. (b) High resolution coronal CT of right temporal bone demonstrating an approximate 9 mm defect involving the superiomedial external ear canal and tegmen mastoideum.
CRIOT2015-121028.001.jpg
PMC4364359_01_CRIOT2015-121028.001.jpg
fig1
High-resolution CT of the temporal bones demonstrated opacification of the right mastoid cavity with ossicular chain erosion (Figure 1(a)). A 9 mm bony defect of the tegmen tympani was evident (Figure 1(b)).
(a) T2-weighted MRI axial image demonstrates a smooth bordered heterogenous hyperintense mass approximately 55 mm x 48 mm with surrounding cytotoxic oedema of brain tissue. (b) T2-weighted MRI coronal image demonstrates the mass extending approximately 52 mm superiorly into the temporal lobe from the right middle ear via tegmen mastoideum defect.
CRIOT2015-121028.002.jpg
PMC4364359_01_CRIOT2015-121028.002.jpg
fig2
T2-weighted axial MRI scans showed a well demarcated heterogeneous mass approximately 55 mm x 48 mm centred within the right temporal lobe extending from the right tegmen defect with cytotoxic oedema of the surrounding brain tissue (Figures 2(a) and 2(b)).
Temporal craniectomy and corticotomy demonstrates a pearl white mass lesion consistent with cholesteatoma in the middle cranial fossa.
CRIOT2015-121028.003.jpg
PMC4364359_01_CRIOT2015-121028.003.jpg
fig3
The lesion was initially debulked, and then the densely adherent capsule was removed (Figure 3).