Polyps of the ear are usually restricted to the external ear canal, and are associated with otorrhea (ear drainage). Cholesteatoma is a thin-walled cyst that occurs within the middle ear space, where it may cause destruction of bone, including the small middle ear bones, or ossicles, which are essential for the conduction of sound energy to the inner ear. A case is reported of a polyp located in the auditory (eustachian) tube, a conduit connecting the nasopharynx with the middle ear and allowing for the equalization of pressure within the middle ear. The case involved a 41-year-old woman with a mild hearing deficit that had begun in childhood and had recently worsened following a cold. The patient also complained of ringing noises in her ears (tinnitus). The patient's hearing loss was confirmed by conventional testing, and examination also disclosed a polyp located deep within the nose, as well as a modestly deformed ear anatomy. A tomogram (a sophisticated X-ray technique) demonstrated that the patient's right auditory canal was narrow and that the middle ear space was distorted. At surgery her right middle ear was opened through the tympanic membrane (eardrum) and a gelatinous substance was found within the space. A small tube was inserted through the tympanic membrane to allow for ventilation of the middle ear space, and to aid in clearing the cavity of exudate. Examination of the auditory tube produced a dumbbell-shaped polyp filling and obliterating the lumen (canal) of the tube. The polyp was surgically removed. Her hearing was nominally improved and she was fitted with a hearing aid. Approximately 10 years latter she was seen again for similar complaints. A small hole was found in the left tympanic membrane, and a new cyst was found in her right tympanic tube, which was again removed. A cholesteatoma was confirmed within her right middle ear and removed at a subsequent operation. Review of the patient indicates that she had a mild form of congenital underdevelopment of the bones of skull and ear. This case is unique in the association of a congenitally abnormal ear and the development of an aural (ear) polyp. It is unknown whether the cholesteatoma was the result of the previous surgery or whether it developed spontaneously, perhaps being present, but quiescent at the time of the first surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)