Giant Aural Cholesteatoma - A Case Report

We present a 65 year old male, who developed giant Cholesteatoma with intracranial extension, multiple cranial nerve palsies, lateral sinus thrombosis with obliteration and post aural fistula. The Patient had foul smelling discharge from right ear since childhood. He complained of headache and LMN type of facial paralysis (right) since 6 months. Patient underwent Right Modified Radical Mastoidectomy few months back but the post aural wound didn’t heal. As we saw and evaluated the patient CT and MRI Imaging showed extensive cholesteatoma involving entire temporal bone, part of occipital bone, extending into zygomatic bone, medially encroaching jugular foramen, and postero-inferiorly up to C1 and C2 vertebra, extended intracranially into both middle and posterior cranial fossa. Using skull base surgical principles entire cholesteatoma excised, patient had uneventful follow up for 6 months. This case emphasizes the value of pre-operative radiological assessment; we present this case because of rarity of giant cholesteatoma.