A 15 years old female patient with 3 months history of RT sided facial paralysis which was treated by the neurologist as Bells Palsy before consulting the author. The tympanic membrane was dull looking but intact. CT showed a soft tissue mass filling the middle ear, mastoid cavity and was extending to the petrous apex. Mastoid exploration revealed the real nature of the soft tissue mass as cholesteatoma for which radical mastoid surgery was done. This view is during the postoperative follow up. It shows the middle ear cavity, mastoid cavity and the cavity medial to the superior canal which extends to the petrous apex.
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