Fine‐needle aspirates and computed tomography assisting in the diagnosis of cholesteatoma in a dog with recurrent otitis

Summary A 10‐year‐old, male, neutered Bichon‐Frisé, with a history of recurrent otitis externa, was presented to a referral centre with sudden‐onset head tilt. Neurological examination was consistent with right peripheral vestibular syndrome and facial neuropathy. There was suspicion of an expansile ear mass on skull radiographs, which was confirmed with computed tomography. A fine‐needle aspiration sample showed abundant aggregates of keratin material associated with yeast microorganisms compatible with Malassezia spp. Based on the imaging and cytology findings, a final diagnosis of a cholesteatoma was made. The mass was invasive and was deemed inoperable due to significant intracranial involvement. The patient was treated palliatively and was subsequently euthanased by the referring vets due to comorbidities, approximately 1 year after presentation.