OtoRhinoLaryngology Portal

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OtoRhinoLaryngology Portal Video Collections

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Cholesteatoma: Post-Surgery Images

Curvi-linear scar over the incisura area.

Fine healed post-auricular curvilinear surgical scar.

Wide meatoplasty.

Intact right malleolar-incudal complex in the epitympanum after

healed cholesteatoma surgery. Posteriorly leads to aditus ad-antrum.

View of epithelialized postero-superior cholesteotoma after ear toilet performed.

Healed atticotomy cavity and cholesteatoma-free.

Figure shows epitheliazed post-atticotomy cavity

with some earwax cumulation superiorly.

The epitympanum view after ear toilet showing missing

head of malleus with its adjoining body of incus.

 Figure shows the facial nerve (arrow) course in the middle

(horizontal segment) before it turns inferiorly as the

vertical segment a patient who had surgery perfomed for atticoantral disease.

 Horizontal segment of facial nerve (arrow)

 A clean mastoid cavity.

The high-definition image of the same patient's mastoid cavity above.


Figure shows a well-epithealized mastoid cavity after a canal wall down surgery.

Mastoid cavity with epithelial crusts and some earwax.

Figure shows a localized entrapped keratin (arrow) 

in a patient who had canal wall down surgery for cholesteatoma.

Early recurrence of cholesteatoma in a mastoid cavity manifested as epithelial pearls (arrows).  (TM - tympanic membrane, A - anterior, P -posterior)

Ear Inspection and Toilet of Mastoid Cavity

Follow-up assessment and inspection serve several objectives:

i. To monitor healing and recovery.

ii.To clean the cavity from epithelial debris or earwax cumulation.

iii.To detect and treat concurrent infection e.g. otomycosis.

iv.To diagnose residual or recurrence disease and plan for further therapeutic intervention.


Another example showing crusts (arrow) in a well-epitheliazed cavity.


Otomycosis occuring after cholesteatoma surgery.

Paediatric Cholesteatoma Surgery

Sequential endoscopic images of right auditory meatus showing post-surgery changes in a 4 year old child who had cholesteatoma operation 2 years earlier.  Except for the hearing loss, she is otherwise asymptomatic.

Epithelial Migration of The Mastoid Cavity Epithelium

 (Epithelial migration figures are courtesy of Dr G Revadi)

Bony Anatomy of Temporal Bone after Mastoidectomy

1- squamous portion, 2- zygoma, 3- mastoid portion, star- mastoid tip,

red arrow- tympanic plate, blue arrow- parietal notch.