Cholesteatoma

Question 1

What is it?

Answer 1

Abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum.

Question 2

Causes

Answer 2

Chronic middle ear infections
Poor eustachian tube function

Dysfunction of the eustachian tube results in negative pressure in the middle ear.
This negative pressure sucks in the tympanic membrane forming a ‘retraction pocket’.
Once deep enough, the pocket traps keratin debris and develops into a cholesteatoma.
This can become infected leading to chronic ear discharge.

Question 3

What does it lead to?

Answer 3

Bony destruction

Invasion into neighbouring structures

Question 4

S+S:

Ear - 3

Invasion

Where would you see crusting on otoscopy?

Answer 4

Unilateral conducive hearing loss
Offensive otorrheoa
Vertigo

CN7 palsy - facial
Meningitis or brain abscess

Otoscopy may show crust in pars flaccida

Question 5

Management

Answer 5

Surgical removal