1. Cholesteatoma

2. Case History Ossicular Reconstruction Cholesteatoma Case 1 12 yr old male Left Congenital Cholesteatoma Surgical Reconstruction of ossicular chain and tympanoplasty

3. SRT/WR

4. Audio

5. Cholesteatoma Case 2 58 y/o female Hx of bilateral cholesteatoma Hx of multiple bilateral ossicular chain reconstructions, stapedectomy and tympanoplasty Hx of mastoidectomy

9. Cholesteatoma Case 3 57 y/o male Hx of Left tympanoplasty, mastoidectomy, and ossicular chain reconstruction

14. Cholesteatoma Case 4 History 12 y/o Male History of right cholesteotoma Hx of Eustachian Tube dysfuction Removed cholesteotoma and placed subannular tubes in May 04

15. Otoscopy Bilateral atelactasis No tubes Pin point perferation right?

20. Case 5 History 62 year old female Recent right tympanoplasty and ossicular chain prosthesis placement 6 months prior

21. Otoscopy Right reveals a well healed tympanic graft Left is within normal limits

25. Cholesterol granuloma History 41 year old male Six to eight week history of low-grade left sided headaches – aggrivated by straining and valsalva. Recent transient stabbing type pain in left temporal area Sent to Shands after a CT scan showed a cholesterol granuloma – for biopsy/draining

26. CT Scan (note our patient has it on the opposite side, it is in the middle ear space)

27. Otoscopy There are exostoses in both ear canals obscuring full view of TM

32. Case 6 History 79 year old male Recent tympanoplasty and canaloplasty for a right cholesteatoma

33. Otoscopy Pnematic otoscopy reveals grade 4 atelactasis left posterosuperior tympanic membrane with no evidence of cholesteatoma Right TM is intact

38. Case 7 History 13 year old female History of left cholesteatoma Underwent tympanoplasty, modified radical mastoidectomy and ossicular chain reconstruction 3 years prior

39. Otoscopy Granulation tissue found in left mastoid bulb – cauterized with silver nitrate TM on left within normal limits Right TM has developed a retraction of the pars flaccida onto the incus and pars tensa onto the promontory. Weber lateralizes to the right

44. Case 8 History 65 year old female History of right traumatic perforation with subsequent cholesteatoma Right tympanoplasty, bony canaloplasty and ossicular chain reconstruction

45. Otoscopy Left is within normal limits Right external auditory canal showed scant dry skin and residue from sterois drops – removed Graft is healed and there is no evidence of cholesteatoma

49. Case 9 History Preoperative consultation for possible left cholesteatoma History of chronic ear infections Imaging done one month prior showed soft tissue density consistent with cholesteatoma

50. Otoscopy Right is within normal limits Left TM is inflamed and opacified

54. Case 10 History 69 yr old male current Right TM perf Hx of left TM perf with canaloplasty/tympanoplasty performed on the left ear Synthetic ossicular chain reconstruction with stapedectomy in Aug 2005

58. Case 11 History 65 y/o male Motor Vehicle Accident (MVA) Sept ‘01 Right temporal bone fracture with right sided paralysis of face

63. Case 12 History 14 y/o female Fell off the back of a pickup truck going approx 30 mph Left temporal bone fracture she currently has bleeding from the left ear canal

64. Otoscopy Skin laceration on skin of left external auditory canal Left TM seems intact but there is evidence of hemotympanum

69. Case 13 history 21 year old female History of left cholesteatoma with tympanoplasty, ossicular chain reconstruction and tympanomastoidectomy three months prior

70. Otoscopy Right is within normal limits Left shows no retraction pockets and seems to be healing well

75. Case 14 History 76 year old female Four months post left canaloplasty, tympanoplast and ossicular chain reconstruction

76. Otoscopy Right is within normal limits Left TM is dull