Cholesteatoma of the Nose and Maxillary and Ethmoid Sinuses: A Rare Complication of Palatal Surgery

Abstract

A 10-year-old boy presented with a complaint of a leftsided nasal obstruction with an associated foul-smelling discharge. Physical examination and anterior rhinoscopy revealed that a whitish, friable mass had completely fi lled the left nasal cavity. On computed tomography, a softtissue mass was seen fi lling the cavity and extending to the paranasal sinuses with bone erosion. A biopsy of the mass suggested that it represented a cholesteatoma. Th e lesion was removed via nasal endoscopy, and histopathology confi rmed the diagnosis of a cholesteatoma. No recurrence was noted during 6 months of follow-up. Cholesteatoma of the paranasal sinuses is a rare entity, as only a few dozen cases have been reported in the literature.

A Unique Case of Pneumatised Styloid Process with Cholesteatoma

“…The literature reports cholesteatoma at some unusual sites such as frontal [6], maxillary, and ethmoid sinuses [7]. Cholesteatoma within pneumatised styloid process presented here is yet another addition to the list of unusual sites.…”

Rhinitis caseosa

“…a hyperkeratotic epithelium. 3 An expansile cyst will release proteolytic enzymes responsible for the bone eroding properties of the nasal cholesteatoma. 4 The differential diagnosis for this disease is allergic fungal rhinosinusitis, sinonasal malignancy.…”

“…The pathogenesis of rhinitis caseosa is such that it might a secondary condition to a primary pathology causing blockade of the maxillary sinus. This blockade will lead to the normal respiratory epithelium being replaced by a hyperkeratotic epithelium 3. An expansile cyst will release proteolytic enzymes responsible for the bone eroding properties of the nasal cholesteatoma 4.…”