Endoscopic removal of TM cholestestoms

A 3 yo girl was referred to the ENT clinic after her PCP noticed an abnormal TM on the left.

She has a history of a 2 ear infections prior to presentation. She is asymptomatic, with no pain and no drainage from her TM. Her audiogram was normal. Her physical eventually revealed the presence of a relatively large keratin pearl on her TM, without obvious middle ear effusions. After a short period of observation the family decided to have it removed.

The case was performed endoscopically in a trans-canal approach. The lesion was dissected mainly with a straight pick. The fibrous layer underneath was found to be intact and no myringoplasty was necessary.

The patient was was seen again 2 months post-op and her TM was found to be normal with a normal audiogram.

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