Delayed Presentation of Massive Skull Base Cholesteatoma Following Ear Overclosure: The Importance of Radiographic Surveillance

We present the unusual case of a massive skull base cholesteatoma diagnosed in middle-aged woman, 26 years after initial canal overclosure. This case highlights the importance of radiographic surveillance following ear canal overclosure and demonstrates the complex management conundrum when exteriorization would create a deep, gravity dependent, chronically draining cavity in an otherwise asymptomatic patient.