Thursday, June 16, 2011

An interesting otoscopic finding


Erosion of outer attic wall has always been associated with cholesteatoma. Theoretically eustachean tube is found to be not functioning in these patients predisposing to the formation of attic retraction pocket.

Case report:

This case report would make us rethink the pathophysiology of outer attic wall (scutum) erosion.

40 years old female patient presented with hard of hearing right ear of 3 years duration.
She did not give any history of ear discharge / foul smell emitting from the affected ear. Even on prolonged questioning she denied history of ear discharge.
No history of previous ear surgery for any other ailment.

Video otoscopy showed:

1. Thinned out ear drum
2. Ear drum bulging on valsalva
3. The ear drum could be seen moving as the patient breaths indicating a patulous eustachean tube
4. Erosion of outer attic wall (scutum) without the presence of cholesteatoma

This video clipping would ensure that we start rethinking about the pathophysiology of scutum erosion.

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