A Case of Aspergillus Fungal Ball Confined to the Eustachian Tube

We present a case of an Aspergillus fungal ball confined to the bony portion of the Eustachian tube (ET) in a 59-year-old immunocompetent female with chronic otitis media. Preoperative CT revealed a soft tissue density in the bony ET, initially interpreted as mucosal edema. During endoscopic tympanoplasty using the underlay above-the-malleus technique and a 30-degree angled endoscope, a cheese-colored mass was discovered in the bony portion of ET and subsequently removed. Histopathological examination confirmed the lesion as an Aspergillus ball. In conclusion, the soft tissue density observed in the bony ET on the preoperative CT may be mistaken for mucosal edema, highlighting the importance of careful observation. Utilizing a 30-degree endoscope can enhance the visualization of ET.