Clinical Findings of Cholesteatoma Behind an Intact Tympanic Membrane in Adults.

Objective: The aim of this study was to describe the clinical features and surgical results in a series of adult intact tympanic membrane cholesteatoma (ITMC).

Materials And Methods: The author retrospectively analyzed 17 adult patients diagnosed with ITMC who underwent surgery. The author investigated the demographic data, presenting symptoms, endoscopic findings, disease location, surgical technique, post-operative complications, and outcomes.

Results: Diagnosis was made based on a white mass behind an intact tympanic membrane in 14 cases and on explorative surgery and CT in the remaining 3 patients. ITMC presented as a cystic lesion with a complete capsule. ITMCs were removed through an endoscopic endaural approach combined with cartilage myringoplasty in 14 cases and intact canal wall mastoidectomy was performed in 3 cases. No recurrent cholesteatoma or iatrogenic sensorineural hearing loss was observed during the follow-up period. The mean ABG was 17.7 ± 2.7 dB perioperatively and 10.2 ± 1.3 dB postoperatively.

Conclusions: Intact tympanic membrane cholesteatoma in adults may have both congenital and acquired origins, but it is not possible to differentiate between a slow growing acquired or indolent congenital cholesteatoma. ITMC typically presents as a cystic lesion with a complete capsule that can be treated successfully via an endoscopic tympanotomy approach, but in a minority of cases a more extensive mastoidectomy may be required.