ENT Tumours

Question 1

what is a cholesteatoma?

Answer 1

presence of keratinising epithelium within the middle ear or in other pneumatised areas of the temporal bone
this keratinising epithelium exhibits independent growth leading to expansion and to resorption of underlying bone

Question 2

symptoms of cholesteatoma?

Answer 2

hearing loss
ear discharge (may be foul smelling)
vissible mass (yellowish white substance) behind intact tympanic membrane
visible crusting

Question 3

risk factors for cholesteatoma?

Answer 3

middle ear disease
eustachian tube dysfunction
ear surgery
congenital anomalies (eg cleft palate or craniofacial abnormalities)

Question 4

how is cholesteatoma diagnosed?

Answer 4

tissue sample for pathology
CT (would show opacification of middle ear or mastoid, erosion of scutum/ossicular chain/labyrinth/facial canal/bony capsule of sigmoid sinus)

Question 5

how is cholesteatoma managed?

Answer 5

surgery = definitive

mastoidectomy

Question 6

complications of cholesteatoma surgery?

Answer 6

recurrence
hearing loss
labyrinth fistula

Question 7

what is a vestibular schwannoma/acoustic neuroma?

Answer 7

benign cerebellopontine angle tumour that grows from vestibular component of vestibulocochlear nerve

Question 8

how does vestibular schwannoma/acoustic neuroma present?

Answer 8

unilateral sensorineural hearing loss
facial numbness
dizziness
tinnitus
difficulty localising sounds