Learning Objectives: Case study.

It is well known the cholesteatoma causes bone erosion and destruction of ossicular chain. We experienced two cases of cholesteatoma accompanied by abnormal ossification around ossicles which showed fixation to the wall of antrum or bony wall of middle cranial fossa. Case 1 is a 39-year-old man. He visited our hospital complained hearing loss of his left ear about one year ago. He also complained otorreah of left side six months ago, cured spontaneously. 10 years ago he had visited our hospital for his right ear surgery, then an otomicroscopic examination of his left ear showed only dry small retraction pocket. But this time the retraction pocket of his left ear had been enlarged. Computed tomography scanning (CT) revealed deformity of ossicles. An operation of his left ear was performed. Abnormal ossification was seen around malleus head and Incus body and fixed the wall of antrum. Isolated cholesteatoma was existed behind the malleus head. Case 2 is a 45-years-old woman. At the age of 23, her left ear had been operated for cholesteatoma in our hospital. 8 years later she visited our hospital for his right otalgia. An otomicroscopic examination of her right ear revealed the retraction pocket with large squamous debris. By conservative treatment her otalgia was cured and the retraction pocket was cleaned. CT revealed only small soft tissue in attic. At this time the age of 45, the debris of the retraction pocket couldn't be removed for pain. CT revealed large soft mass with defect of bony wall of middle cranial fossa. An operation of her left ear was performed. Ossicles fixed wall of antrum and isolated cholesteatoma by the abnormal ossification was found. It will be necessary to take into consideration of the existence of isolated cholesteatoma by abnormal ossification.