PMC8558794_01
Otoendoscopic pre-operative evaluation, granulations at the attic and posterosuperior quadrant.
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The pars tensa of the tympanic membrane was intact (Figure 1).
CT temporal bone, axial and coronal view, showing cavity and soft tissue lesion (white solid arrow).
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However, the facial nerve canal, internal acoustic meatus, cochlea, and vestibule were intact (Figure 2).
(a) Postaural incision, out-to-in approach. (b) Mastoid cyst occupying the mastoid cavity. (c) Final view after canal wall down mastoidectomy. (d) Gross picture of cyst wall. (e) Histopathological finding of the granulation and cyst wall. Attenuated cyst wall lining (**) and multinucleated giant cell (solid black arrow) and (f) postoperative picture after completion of antitubercular chemotherapy.
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The patient underwent modified radical mastoidectomy under general anesthesia, via a postaural approach using the out-to-in technique (Figure 3(a)). Upon drilling the mastoid, a cystic lesion was encountered (Figure 3(b)). Stapes suprastructure was partially necrosed (Figure 3(c)). The cyst wall along with granulations tissues were sent for histopathological examinations (Figure 3(d)). The cyst wall lining epithelium was attenuated with chronic inflammatory cells infiltration and giant cell reaction (Figure 3(e)). The antitubercular medications were started for the patient, and finally, the patient recovered after completion of chemotherapy (Figure 3(f)). The patient was followed up for 1 year, the cavity healed however, the hearing did not improve.