Virtual Patients - Otology - Otorrhea

The patient undergoes a pre-operative CT scan with the report shown below.

CT head and temporal bones

 

Slight motion artifact. 

 

Intracranial appearances are normal. 

 

The right middle ear cleft and mastoid air cells are normal with an intact ossicular chain.  

 

There is hypodense homogeneous partial opacification of the left middle cleft ear and mastoid air cells. This is associated with significant erosion of the ossicular chain but no dehiscence of the bony scutum, tegmen and no evidence of erosion into the middle cranial fossa. 

 

Conclusions

Findings are consistent with a left-sided cholesteatoma with destruction of the ossicular chain. 

 

When consenting the patient for surgery, the ENT registrar states that the risks of surgery are the same as the risks of leaving the cholesteatoma untreated.

 

Question.

 

Which of the following are not a recognised complication of a cholesteatoma?