Causes Of Mistaken Diagnosis Of Congenital Cholesteatoma In Middle Ear

ObjectiveTo reduce mistaken diagnosis of congenital cholesteatoma in middle ear.Methods During the year of 1996 1—2005 9 cases with congenital cholesteatoma were misdiagnosed as the other diseases and analyzed retrospectively in our hospital. Among them, male 6,female 3.left ear 4,right ear 5.the ages were from 8 to 53,average age was 18.88 ages..9 cases were misdiagnosed as the other diseases: 5 were chronic suppurative otitis media(55.56%),1 was otosclerosis(11.11%) ,2 were retroauriculares supprative lymphadenitis (22.22%), 1 was polyp of external auditory canal(11.11%). The shortest misdiagnosed time was 20 days, the longest that time was 13 years, average time was 4.54 years. The rate of misdiagnoses was 100%.9 patients were all misdiagnosed peroperation. the finding of cholesteatoma during the operation, and mading the precise diagnose combined with the result of pathology. the eargrums of 7 patients were intact, 1 patient was microtia, the other patient's temporal bone was damged extensively, and tympanic member perforation was fissural located in anteroinferior quadrant.Results There were four causes for misdiagnosis of congenital cholesteatoma: 1. equivocal symptoms and careless examination; 2. carelessness in history–talking and the lack of a comprehensive study for the symptoms and physical signs; 3.diagnosis were limited by the poor medical condition; 4. the lack of recognition for congenital cholesteatoma.Conclusions Improve comprehension for congenital cholesteatoma. A complete and comprehensive analysis should be made on the basis of the age, the past history, careful examination, audimetry measurements and image date. Folium CT scan of temporal bone should be a routine measurement for congenital cholesteatoma.