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Cholesteatoma
Aka: Cholesteatoma
- Pathophysiology
- Benign squamous metaplasia of middle ear epithelium
- TM epithelium retracts into mastoid air cells
- Mass gradually expands and keratinizes
- Forms epithelial inclusion cyst
- Contains Cholesterol crystals and keratinous debris
- Results in destruction of middle ear ossicles
- Conductive Hearing Loss
- Cause
- Congenital Cholesteatoma
- Acquired Cholesteatoma
- Chronic Otitis Media
- Tympanic Membrane Rupture
- Symptoms
- Ear fullness
- Ear Pain
- Headache
- Hearing Loss
- Chronic suppurative discharge from middle ear
- Via perforated Tympanic Membrane
- Signs
- Middle ear deafness
- Otoscope Exam
- Pearly gray middle ear mass
- Radiology
- Bony Erosion and enlargement of middle ear
- Mastoid process with air cell opacification
- Management
- Surgical excision of Cholesteatoma
- Second look procedure may be scheduled at 6 months
- Complications
- Conductive Hearing Loss
- Mastoiditis (most common cause)