Congenital Mastoidal Cholesteatoma in an 87-Year-Old Woman Treated by Watchful Waiting

Congenital cholesteatoma (CC) of the ear is a benign, slow-growing epidermoid cyst consisting of keratinized squamous epithelium, which may expand and destroy surrounding tissues. For a clinical case to be considered as a CC, there should be no previous history of tympanic disease, such as tympanic membrane retractions or ear discharge, and no previous ear surgery. This occurs most commonly in the middle ear, and because it typically causes ossicular erosion with hearing impairment, detection tends to occur relatively early.