Cholesteatoma

Which of the following is the most common site of origin of acquired cholesteatoma in the middle ear?

A 35-year-old woman from Tamil Nadu presents with a 3-year history of painless, progressive hearing loss and recurrent ear discharge from the right ear since childhood. She reports occasional vertigo triggered by loud sounds (Tullio phenomenon). On otoscopy, a white, pearly mass is visible in the posterosuperior external auditory canal. Tragal pressure causes vertigo and nystagmus. Weber test shows conductive hearing loss on the right. What is the most likely diagnosis and what is the underlying mechanism of the Tullio phenomenon?

A 35-year-old man presents with chronic ear discharge and conductive hearing loss. Otoscopy reveals a retraction pocket in the posterosuperior quadrant of the tympanic membrane. CT temporal bone shows an expansile lesion eroding the ossicles and lateral semicircular canal. Regarding the pathophysiology and clinical features of cholesteatoma, all of the following are true EXCEPT:

A 35-year-old woman presents with a 6-month history of foul-smelling otorrhea and progressive conductive hearing loss. Otoscopy shows a perforation in the posterosuperior quadrant with granulation tissue and bone erosion on high-resolution CT. Which finding would best distinguish this as acquired cholesteatoma rather than a simple chronic suppurative otitis media (CSOM)?

A 42-year-old woman undergoes surgery for cholesteatoma. Intraoperatively, the surgeon suspects residual disease despite careful dissection. Which investigation is most appropriate to detect residual cholesteatoma in the immediate postoperative period?