Cholesteatoma

Question 1

What is a cholesteatoma?

Answer 1

Rare complication of chronic otitis media
Non cancerous
Abnormal accumulation of skin, squamous epithelium and keratin debris within middle ear cleft and mastoid air cells.
Causes local destruction

Question 2

Presentation of cholesteatoma?

Answer 2

Foul smelling, non-resolving discharge
Hearing loss
Vertigo
Facial nerve palsy
Cerebellopontine angle syndrome

Question 3

What is seen on otoscopy of pt w/ cholesteotoma?

Answer 3

Attic crust - seen in the uppermost part of ear drum (retraction pocket)

Question 4

Investigations for cholesteatoma?

Answer 4

Pure tone audiogram
CT scan of petrous temporal bones

Question 5

Differentials for cholesteotoma?

Answer 5

Chronic otitis media
Otitis externa
Benign necrotising otitis externa

Question 6

Management for cholesteotoma?

Answer 6

Surgical removal - canal wall up mastoidectomy

Question 7

Complications of cholesteotoma?

Answer 7

Recurrance
Hearing loss
Labyrinthine fistula
Facial palsy
Meningitis
Brain abscess
Mastoiditis