Cholesteatoma Flashcards
What is cholesteatoma
Growth of keratinising squamous epithelium in the middle ear +/- mastoid process
What gender predominantly gets cholesteatoma
Males
How do we classify causes of cholesteatoma
Acquired or congenital
Name some acquired causes of cholesteatoma
Chronic otitis media, perforated tympanic membrane
Where does acquired cholesteatoma tend to be found
In the posterior superior middle ear / petrous apex
What causes congenital cholesteatoma
Proliferation of the embryonic crest
Where does congenital cholesteatoma tend to be found
Anterior superior middle ear
What is a risk factor of cholesteatoma
History of frequent ear surgery
Pathophysiology of cholesteatoma
Keratin becomes trapped and builds producing a pearly white mass in the middle ear
Erodes bone as it expands
Histology of cholesteatoma
Squamous epithelium with abundant keratin production
Associated with inflammation
Clinical presentation of cholesteatoma
Asymptomatic at the beginning
Unilateral discharge; persistent or recurring, foul smelling
Conductive hearing loss
Symptoms associated with progressing cholesteatoma
Vertigo, sensorineural hearing loss, facial palsy, meningitis, intracranial abscess
Investigation of cholesteatoma
Otoscopy: shows defect in the tympanic membrane full of white material
Retraction visible before development
Management of cholesteatoma
Mastoid surgery to remove the sac of debris, reconstruction
Complications of cholesteatoma
Subperiosteal abscess, sensorineural hearing loss, tinnitus, vertigo, meningitis
