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Abstract
The case of an eleven-year-old girl with no previous ear disease, normal tympanic membranes and hearing, who contracted an external otitis, is presented. The course of the disease necessitated further investigation, and during this a cholesteatoma the size of a grape was found in the mastoid process. During the operation one found normally developed air cells in the mastoid process, and by exploration of the middle ear one found no inflammatory changes.
The growth of this cholesteatoma may most easily be explained on the assumption of an embryological origin. The embryological cell rests must probably have had such a position that during a certain stage of their concentrical growth they reached the aditus and at the same time penetrated the bony wall of the external meatus. The ever-increasing pressure caused by the expansion of the cholesteatoma has in that way been relieved and the function of the middle ear preserved.
The process remained symptomless and was first recognized when it penetrated the wall of the meatus whereby it became infected causing chronic suppuration.