Question 2666
{"accessible":true,"alternatives":[{"id":13050,"text":"cholesteatoma"},{"id":13051,"text":"otitis media"},{"id":13052,"text":"paraganglioma"},{"id":13053,"text":"schwannoma"}],"archived":false,"correctAlternativeId":13050,"explanation":"\u003cp\u003eA cholesteatoma is a mass of desquamated keratinized squamous epithelium which is histologically equivalent to an epidermoid cyst. It most commonly arises from the pars flaccida of the tympanic membrane. Pars flaccida cholesteatomas are typically centered in the Prussak space as in this case. Cholesteatomas in the pars tensa region are uncommon and characterized by location in the sinus tympani or facial recess. Cholesteatomas may erode surrounding structures including the ossicular chain, scutum, mastoid bone, or bony labyrinth. This case erodes the scutum. \u003c/p\u003e\u003cp\u003eSchwannomas of the temporal bone may arise from the vestibular nerve, or rarely, the facial nerve. Vestibular schwannomas are located in the internal auditory canal. Facial nerve schwannomas are usually well-circumscribed fusiform enhancing mass along the course of the intratemporal facial nerve, but tympanic segment facial nerve schwannoma can be pedunculated and occupy the middle ear. However, the location is not in Prussak’s space. \u003c/p\u003e\u003cp\u003eA paraganglioma is a slow growing tumor arising from paraganglion cells and occurs around the cochlea promontory in the middle ear (glomus tympanicum tumor). This lesion is not located at the cochlea promontory. \u003c/p\u003e\u003cp\u003eOtitis media is middle ear infection. It can lead to soft tissue density opacification of the middle ear, but would not cause bone destruction of the scutum as seen in this case.\u003c/p\u003e","id":2666,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/1045/MCQs_Hoang_Q2_big_gallery.jpeg","imageAttribution":{"kind":"external","attribution":"Jenny Hoang"},"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2666","nextQuestionPath":"/articles/schwannoma/questions/1662","relatedArticles":[{"id":1116,"title":"Cholesteatoma","link":"/articles/cholesteatoma?lang=us"},{"id":1843,"title":"Paraganglioma","link":"/articles/paraganglioma-1?lang=us"},{"id":48711,"title":"Otitis media","link":"/articles/otitis-media?lang=us"}],"alsoUsedIn":[{"id":267,"kind":"LiveSchedule","title":"267","link":"https://radiopaedia.org/admin/live_schedules/267"},{"id":1719,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1719","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1719"},{"id":365,"kind":"LiveSchedule","title":"365","link":"https://radiopaedia.org/admin/live_schedules/365"},{"id":270,"kind":"LiveSchedule","title":"270","link":"https://radiopaedia.org/admin/live_schedules/270"},{"id":1472,"kind":"Course","title":"2023 Virtual Conference Private Use - page 1472","link":"https://radiopaedia.org/courses/2023-virtual-conference-private-use/pages/1472"},{"id":1472,"kind":"Course","title":"Head \u0026 Neck Lectures - page 1472","link":"https://radiopaedia.org/courses/head-neck-lectures/pages/1472"}],"stem":"\u003cp\u003eA 35-year-old male presents with unilateral hearing loss and otorrhea. Which of the following is the most likely diagnosis from this image?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2666"}],"attemptsPercentages":[{"alternativeId":"13053","percentage":1},{"alternativeId":"13052","percentage":2},{"alternativeId":"13050","percentage":89},{"alternativeId":"13051","percentage":7}],"promptToLogin":false,"questionManager":false,"articleId":"schwannoma"}