Recurrent colesteatoma with atypical presentation with zygomatic extension. A case report

Introduction and objective: The surgical treatment of cholesteatomatous chronic otitis media (OMC) is in most cases mandatory. However, the treatment of this entity is a huge challenge for the otologic surgeon, and persistence or recurrence may occur, especially in closed mastoidectomy cavities. Description: A 52-year-old woman with a history of OMC cholesteatomatous, submitted to left closed tympa-nomastoidectomy 20 years ago. It was presented in external consultation with voluminous subcutaneous lesion at the level of the external auditory canal, extending superiorly to the temporal region. She underwent mastoidectomy with excision of the lesion, which turned out to be recidivant cholesteatoma. Conclusions: The main disadvantage of closed mastoidectomy is the higher rate of associated residual/recurrent disease. This case highlights the fact that, because of the high relapse rate, these patients should maintain a broad follow-up and that the presentation of a cholesteatoma recurrence may not be typical.