A Young Child Has a Pale, Whitish Discoloration Behind the Tympanic

A young child has a pale, whitish discoloration behind the tympanic membrane. The provider notes no scarring on the tympanic membrane (TM) and no retraction of the pars flaccida. The parent states that the child has never had an ear infection. What do these findings most likely represent?

A) Chronic cholesteatoma
B) Congenital cholesteatoma
C) Primary acquired cholesteatoma
D) Secondary acquired cholesteatoma