Bhutta, Mahmood F., Williamson, Ian G. and Sudhoff, Holger H.
Easily missed? Cholesteatoma
BMJ, 342, . (doi:10.1136/bmj.d1088).
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A 24 year old man presented to his general practitioner several times over a year with an intermittently discharging left ear and associated hearing loss. Visualisation of the tympanic membrane was not possible owing to otorrhoea and oedema in the external auditory canal. He was treated for presumed otitis externa with repeated courses of topical antibiotic drops, but as improvement was only temporary he was referred to a specialist. An otolaryngologist cleared the external auditory canal of debris (“aural toilet”) and discovered a cholesteatoma arising from the left tympanic membrane; this was successfully treated by surgical excision.
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