Histologic Correlation

CA 12-month-old girl presented with a history of recur-rent episodes of otitis media. At that time, the patient underwent bilateral myringotomies with insertion of pres-sure equalization tubes. Thick, gluelike material was aspi-rated from eachmiddle ear space, more on the left than the right side. After pressure equalization tube placement, per-sistent left otorrhea developed. Because of the suspicion of a cholesteatoma, an exploratory tympanotomy was per-originate from the area of the hypotympanum and eusta-chian tube. The mastoid was filled with mucoid fluid; how-ever, no mass was noted in the epitympanum or the mas-toid. To ensure complete removal of the lesion, the eustachian tube was cannulated from the middle ear to the parapharyngeal space with a suction catheter. Microscopic examination showed a polypoid mass of connective tissue, covered by keratinizing stratified squa