Snapshot A 29-year-old man presents with unresolved left ear pain for the past 5 months. He also states to having a relative hearing loss of the left ear with occasional tinnitus. Medical history is significant for otitis media that was treated with appropriate antibiotics. He reports completing the course of antibiotics. On physical examination, there is an amorphous, white debri in the left middle ear. Preparations are made to undergo a non-contrast computer tomography (CT) scan of the temporal bone. Introduction Overview login to view 1 more bullet Epidemiology Incidence login to view 1 more bullet Demographics login to view 2 more bullets Location login to view 1 more bullet Risk factors login to view 3 more bullets ETIOLOGY Pathophysiology login to view 5 more bullets Presentation Symptoms login to view 6 more bullets Physical exam login to view 3 more bullets Imaging Computed tomography (CT) scan login to view 2 more bullets Studies Clinical diagnosis Differential Bulging acute otitis media Otitis externa Tympanosclerosis Treatment Operative login to view 3 more bullets Complications Hearing loss Acute mastoiditis Brain abscess Subperiosteal abscess Prognosis There may be recurrence of cholesteatoma post-surgery