CC BY-NC-ND 4.0 · Annals of Otology and Neurotology 2018; 01(02): 115-119
DOI: 10.1055/s-0038-1675663
Case Report
Indian Society of Otology

Differential Presentation of Congenital Cholesteatoma in Twins with Atypical Location

Udayabhanu HN
1   Department of Otology, Neurotology, and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy
,
Lorenzo Lauda
1   Department of Otology, Neurotology, and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy
,
Antonio Caruso
1   Department of Otology, Neurotology, and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy
,
Mario Sanna
1   Department of Otology, Neurotology, and Skull Base Surgery, Gruppo Otologico, Piacenza-Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
04 January 2019 (online)

Abstract

Objective We present an extremely rare report of congenital cholesteatoma (CC) in identical twins with atypical location.

Methods Two consecutive cases of CC in identical twins from diagnosis to treatment and a literature review are presented.

Results The twin children presented to our otology and lateral skull base clinic with different clinical picture. Both underwent thorough audiological workup and imaging and early surgical intervention. The 6-year follow-up of these two children has been uneventful with no recurrence of disease and hearing restoration.

Conclusion Multiple theories exist to explain this rare pathology. Modified Levenson’s criteria define it as white mass behind intact tympanic membrane. Atypical location of CC with recurrent otitis media is not uncommon; hence, further study is required. To our best knowledge, this is the second reported occurrence in identical twins but first report with differential presentation and atypical location in both cases.

 
  • References

  • 1 Sanna M, Zini C. “Congenital cholesteatoma” of the middle ear. A report of 11 cases. Am J Otol 1984; 5 (05) 368-373
  • 2 Sanna M, Caruso A, Russo A. Color Atlas of Endo-Otoscopy: Examination-Diagnosis-Treatment. 1st ed. New York, NY: Thieme publishers; 2017
  • 3 Derlacki EL, Clemis JD. Congenital cholesteatoma of the middle ear and mastoid. Ann Otol Rhinol Laryngol 1965; 74 (03) 706-727
  • 4 Levenson MJ, Parisier SC, Chute P, Wenig S, Juarbe C. A review of twenty congenital cholesteatomas of the middle ear in ­children. Otolaryngol Head Neck Surg 1986; 94
 (05) 560-567
  • 5 Michaels L. An epidermoid formation in the developing middle ear: possible source of cholesteatoma. J Otolaryngol 1986; 15 (03) 169-174
  • 6 Kojima H, Miyazaki H, Tanaka Y, Shiwa M, Honda Y, Moriyama H. [Congenital middle ear cholesteatoma: experience in 48 cases] [in Japanese].. Nippon Jibiinkoka Gakkai Kaiho 2003; 106 (09) 856-865
  • 7 House JW, Sheehy JL. Cholesteatoma with intact tympanic membrane: a report of 41 cases. Laryngoscope 1980; 90 (01) 70-76
  • 8 Teed RW. Cholesteatoma Verum tympani: its relationship to the first epibranchial placode. Arch Otolaryngol 1936; 24 (04) 455-474
  • 9 McGill TJ, Merchant S, Healy GB, Friedman EM. Congenital ­cholesteatoma of the middle ear in children: a clinical and histopathological report. Laryngoscope 1991; 101( 6 Pt 1) 606-613