Cholesteatoma

Question 1

What are the common examination findings?

Answer 1

Hearing loss

Associated discharge

Characteristic appearance of otoscopy

Question 2

What are the investigations?

Answer 2

To finish the exam i would like to - full crania nerve examination and refer to audiometry

By the bed - History, obs

Bloods - FBC

Imaging - CT to see the extent of the damage

Question 3

What are the key investigation findings?

Answer 3

Conductive hearing loss

CT scan will show the extent of the damage as it can cause:

Mastoiditis

Abscess

Meningitis

Erosion of ossicles

Question 4

What is the treatment?

Answer 4

Conservative - Exaplain what it is and what has happened. Also after treatment to come back if symptoms return or start in the other ear

Medical - Regular cleaning +/- antibiotics

Surgical - Surgical cleaning and removal of the cholesteatoma via partial mastoidectomy

Question 5

What are the risk factors?

Answer 5

• Having one previously
• Age 10-20
• Trauma
• Grommets