Acute unilateral hearing loss as an unusual presentation of cholesteatoma

Daniel Thio¹ , Shahzada K Ahmed² and Richard C Bickerton³

¹Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK

²Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK

³Department of Otorhinolaryngology, South Warwickshire General Hospitals NHS Trust Warwick CV34 5BW UK

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BMC Ear, Nose and Throat Disorders 2005, 5:9doi:10.1186/1472-6815-5-9


Published:	18 September 2005

Abstract

Background

Cholesteatomas are epithelial cysts that contain desquamated keratin. Patients commonly present with progressive hearing loss and a chronically discharging ear. We report an unusual presentation of the disease with an acute hearing loss suffered immediately after prolonged use of a pneumatic drill.

Case presentation

A 41 year old man with no previous history of ear problems presented with a sudden loss of hearing in his right ear immediately following the prolonged use of a pneumatic drill on concrete.

The cause was found to be a fractured long process of incus which had been eroded by the presence of an attic cholesteatoma.

A tympanomastoidectomy and ossiculoplasty was performed with good result.

Conclusion

Cholesteatomas may be asymptomatic and insidious in their onset. This case illustrates the point that an indolent disease such as this may present in unusual ways and the clinician must always have a high index of suspicion combined with thorough assessment and examination of every patient.