A 22-year-old woman presented with aural discharge and hearing impairment in her right ear. Otoscopy revealed granulation tissue polyp occluding the canal.HRCT scan of the temporal bone revealed soft tissue occupying the EAC,middle ear and mastoid.Mastoid was sclerosed, anteriorly placed sigmoid sinus and low-lying tegmen. PTA showed moderate conductive hearing loss. Polypectomy was done as local procedure. Polyp seemed to arise from epitympanum. Pars tensa was found intact.Canal wall down mastoidectomy was performed in the form of modified Bondy mastoidectomy.Complete erosion of short process of Incus, partial erosion of incus body and malleus head were noticed while maintaining the integrity of incudomalleal and incudostapedial joint with presence of round window reflex.Cholesteatoma extended lateral to ossicle.Gralulation tissue and edematous mucosa were thoroughly cleared.Graft was placed medial to remnant ossicle.Mastoid cavity was partially obliterated with conchal cartilage and bone pete.Follow-up otoendoscopy shows dry, healthy and shallow mastoid cavity.PTA reveals mild conductive hearing loss.
