A true cholesteatoma of the temporal bone is a rare tumor, derived from a congenital epidermal rest.1-6 This is in marked contrast to the rather common pseudocholesteatoma associated with a marginal perforation of the tympanic membrane and chronic aural suppuration.1,3,6,7 During the last year and a half two cases of apparent true cholesteatoma have been treated. One presented itself as a middleear tumor, the other as an idiopathic facial nerve paralysis of seven months' duration.
Case 1.—An 8-year-old boy was first seen in March, 1956, because of left ear pain, for one day, three weeks previously. He had had an earache two years before without otorrhea, but no other ear trouble. A hearing loss had not been noted.
Examination revealed a boy in excellent health with a normal nose, throat, and right ear. There was bulging of the pars flaccida and posterior superior quadrant of the left tympanic