Cholesteatoma Flashcards
1
Q
What is a cholesteatoma?
A
An abnormal accumulation of squamous epithelium and keratinocytes within the middle ear and mastoid air cell spaces
2
Q
How does it occur?
A
- Chronic negative middle ear pressure due to ET dysfunction
- Causes area of TM to be retracted
- This traps the skin cells, they proliferate and expand
3
Q
What are clinical features of cholesteatoma?
A
- Chronic purulent ear discharge
- Unresponsive to antibiotics
- Hearing loss
- Tinnitus
Less commonly - Otalgia, vertigo, facial nerve involvement
4
Q
What will show on examination?
A
- Ear discharge
- Presence of deep retraction pocket in tympanic membrane
- Membrane may be perforated
- Crust or keratin in upper part of tympanic membrane
5
Q
What is the management for cholesteatoma?
A
- Semi urgent referral to ENT, they will do audiology assessment and CT scan
- Aural discharge can be treated with topical antibiotics
- Surgical treatment is a canal wall up mastoidectomy
6
Q
What are the red flags for cholesteatoma?
A
- Facial nerve palsy
- Vertigo
- Meningism
- Intracranial abscess symptoms eg confusion, change in vision, headaches
