IT IS THE purpose of this paper to point out that the congenitally atretic ear is not necessarily a "safe ear," but that cholesteatoma can and does form behind it. That it very seldom does the literature attests to, but that it can happen embryologically upon occasion should be expected. Congenital atresia of the external auditory meatus is neither rare nor unusual.1-7Cholesteatoma developing behind a bony plate is rare, however; we have found it described only four times.8-11At almost the same time that a patient presented this condition, a temporal bone became available to our temporal bone bank which seems to explain its mechanism more simply than evoking metaplasia7or a primary mastoid epithelial rest: the formation of a short length of normal, skin-lined meatus proximal to the atresia plate. Report of a Case On Aug 1, 1966, a 7-year-old white boy presented the history
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Bernard E. Hoenk (1969) studied this question.
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