Abstract
Cholesteatoma is a benign but destructive otologic disease with a tendency to recur or be incompletely removed during primary surgical management. Patients frequently undergo long-term clinical surveillance to facilitate early detection of recurrent disease. In this case report, we describe an interesting finding in a patient with recurrent cholesteatoma. The patient was asked to perform the Valsalva maneuver, which resulted in a large amount of keratin debris being expelled into the external auditory canal. To our knowledge, there are no reports on the use of the Valsalva maneuver in the assessment of cholesteatoma recurrence.