Cholesteatoma Flashcards Preview

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Flashcards in Cholesteatoma Deck (6)
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1
Q

What is a cholesteatoma?

A

An abnormal accumulation of squamous epithelium and keratinocytes within the middle ear and mastoid air cell spaces

2
Q

How does it occur?

A
  • Chronic negative middle ear pressure due to ET dysfunction
  • Causes area of TM to be retracted
  • This traps the skin cells, they proliferate and expand
3
Q

What are clinical features of cholesteatoma?

A
  • Chronic purulent ear discharge
  • Unresponsive to antibiotics
  • Hearing loss
  • Tinnitus
    Less commonly - Otalgia, vertigo, facial nerve involvement
4
Q

What will show on examination?

A
  • Ear discharge
  • Presence of deep retraction pocket in tympanic membrane
  • Membrane may be perforated
  • Crust or keratin in upper part of tympanic membrane
5
Q

What is the management for cholesteatoma?

A
  • Semi urgent referral to ENT, they will do audiology assessment and CT scan
  • Aural discharge can be treated with topical antibiotics
  • Surgical treatment is a canal wall up mastoidectomy
6
Q

What are the red flags for cholesteatoma?

A
  • Facial nerve palsy
  • Vertigo
  • Meningism
  • Intracranial abscess symptoms eg confusion, change in vision, headaches