Management of the association of otosclerosis and cholesteatoma: Which pathology to treat first?

• Published in: International journal of surgery case reports 2022-07, Vol.96, p.107281-107281, Article 107281
• Main Authors: Lyoubi, Mouna, Douimi, Loubna, El Krimi, Zineb, Oukessou, Youssef, Abada, Reda, Rouadi, Sami, Roubal, Mohammed, Mahtar, Mohammed
• Format: Article
• Language: English
• Subjects: Case Report; Hearing loss; Middle ear cholesteatoma; Otosclerosis; Surgery; Temporal bone
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2022.107281

Hearing loss can result from a wide range of pathologies affecting patients of all ages. It may be due to abnormalities of the outer, middle or inner ear. In this article, we present a case of a 50 years old female patient presenting to the ENT and Head & Neck surgery department of 20 August hospital, complaining of bilateral hearing loss, in whom clinical examination found right attical retraction pocket with scales and left normal tympanic membrane. Complementary investigations revealed the association of two distinct conditions, rarely described in literature: otosclerosis, and chronic otitis media with cholesteatoma in right ear and left otosclerosis. The challenge in this case was to determine the therapeutic strategy: start with left otosclerosis? the right cholesteatoma? simultaneously treat otosclerosis and cholesteatoma right? •The association of otosclerosis and middle ear cholesteatoma is extremely rare. In the face of hearing loss, it is necessary to carefully analyze the otoscopy and the scanner so as not to miss the coexistence of several pathologies which could influence the functional results.•The management of the association of these 2 pathologies is not standardized and there are no published cases that treat this association.•The therapeutic strategy was proposed and discussed with the patient by our senior surgeon who has extensive experience in ear surgery.•The decision was to start with the ear which suffers from otosclerosis only, then to operate the cholesteatoma of the other ear and finally to complete by possible surgery for otosclerosis.•So far the patient has benefited from stapes surgery of the left ear with good clinical improvement.