THE EXISTENCE of congenital cholesteatomas is an accepted fact; only their frequency is undetermined. It is agreed that they are derived from a congenital epidermal cell rest, but according to Fernandez et al1 they are unimportant for practical purposes. Considering the facial nerve complications involved in the reported cases, which I believe to be of primary or congenital cholesteatomas, this statement is far from acceptable.
Report of Cases
Case 1.—A 9-year-old boy was first seen Dec 19, 1962. Eight weeks previously he had developed a paralysis on the right side of his face, associated with a one-day history of otalgia. He had a complete facial paralysis on the right side, his right tympanic membrane was rather lustrous in appearance, and he had a 15-db conductive hearing loss. There was no perforation of the pars flaccida or pars tensa, the latter being confirmed in my office by microscopic examination. Because of