Congenital cholesteatoma presenting with Luc's abscess
A 5-year-old boy presented with progressive left supra-auricular swelling for 2 weeks associated with left ear pain and low-grade fever. There were no complaints of ear discharge or hearing impairment by the child or parents. There was no recurrent ear pain before. Further history revealed no recent upper respiratory tract infection or trauma. Clinical examination showed a fluctuant mass measured 2 × 3 cm at the left supra-auricular region that was consistent with abscess. Otoscopic examination demonstrated mild edematous external auditory canal with intact tympanic membrane. There was a whitish mass seen medial to the tympanic membrane.\nTympanogram showed type B with failed auditory brainstem response on the affected side and normal hearing on the right side. High-resolution computerized tomography (HRCT) of temporal bone revealed soft tissue mass in middle ear cleft and ossicular destruction suggestive of cholesteatoma and Luc's abscess formation at left temporal bone (Fig. ). Under general anaesthesia, surgical exploration through post-auricular incision confirmed lucs abscess. Further exploration of middle ear and mastoid cavity revealed cholesteatoma eroding all ossicles and involving mastoid bone. Modified radical mastoidectomy was done (Fig. ). Postoperatively, patient recovered well without any complications.