The mastoid air cells are underpneumatized and there is mild opacification in the left mastoid tip. Incidental note is made of bilateral concha bullosa. IMPRESSION: Soft tissue mass in the anterior, medial epitympanum and mesotympanum with mild demineralization of the head of the malleus. This is consistent with a congenital cholesteatoma. END OF IMPRESSION: CT RADIATION EXPOSURE: This CT scan was performed with pediatric dose reduction protocols.