cholesteatoma Flashcards
1
Q
what is a cholesteatoma?
A
A cholesteatoma is an abnormal accumulation of squamous epithelium and keratinocytes within the middle ear or mastoid air cell spaces which can become infected and also erode neighbouring structures.
usually acquired, but rarely can be congenital
2
Q
what are the risk factors for cholesteatoma?
A
- male
- middle ear disease
- Eustachian tube dysfunction
- otological surgery
- trauma blast to ear
- congenital abnormalities
- FH
- use of bisphosphonates
3
Q
what are the complications of choleteatoma’s?
A
- recurrent ear infections
- conductive hearing loss
- labyrinthine fistula
4
Q
in an ear examination, what features suggest a cholesteatoma?
A
- evidence of ear discharge
- presence of deep retraction pocket in the tympanic membrane, with or without granulation tissue/skin debris
- crust or keratin in upper part of TM
5
Q
what are the differentials of cholesteatoma?
A
- otitis media with effusion
- otitis externa
- osteonecrosis of the external auditory canal
6
Q
what symptoms are suggestive of cholesteatoma?
A
- recurrent/ chronic aural discharge
- hearing loss or tinnitus
- otalgia, vertigo, facial nerve involvement
7
Q
how is someone with a suspected cholesteatoma managed?
A
- arrange semi urgent referral to ENT
- they will do audiology assessment and CT scan
- common treatment is a mastoidectomy
- arrange urgent admission if facial nerve palsy or vertigo
