A case of acquired cholesteatoma in an elderly with sudden progression during long-term follow-up

A 71-year-old woman was diagnosed as having asymptomatic attic-type cholesteatoma in her right ear with a slight hearing loss. CT demonstrated a lesion limited to attic and antrum with mild ossicular destruction. Since the patient refused surgery, the lesion was followed up by repeated local cleansing and imaging (CT). The findings were unchanged until 7 years ago from initial diag-nosis, when the cholesteatoma progressed abruptly with vertigo, destructing the middle fossa tegmentum and lateral semicircular canal. Finally, she underwent surgery and the post-operative course was uneventful. This is an instructive case demonstrating difficulty in managing less advanced cholesteatoma in the elderly.