Intraoperative images show a typical pearly appearance of a cholesteatoma (arrow, A), in the aditus ad antrum, next to the posterior wall of the EAC (dashed arrow) and a more irregular cholesteatoma (thick arrow, B) accompanied by granulation tissue. Intraoperative images show a typical pearly appearance of a cholesteatoma (arrow, A), in the aditus ad antrum, next to the posterior wall of the EAC (dashed arrow) and a more irregular cholesteatoma (thick arrow, B) accompanied by granulation tissue. K. Baráth et al. AJNR Am J Neuroradiol 2011;32:221-229 ©2011 by American Society of Neuroradiology