Otolaryngology Book

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Cholesteatoma

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

Cholesteatoma (C0008373)

Definition (MSH)A non-neoplastic mass of keratin-producing squamous EPITHELIUM, frequently occurring in the MENINGES; bones of the skull, and most commonly in the MIDDLE EAR and MASTOID region. Cholesteatoma can be congenital or acquired. Cholesteatoma is not a tumor nor is it associated with high CHOLESTEROL.
Definition (CSP)non-neoplastic keratinizing mass with stratified squamous epithelium, frequently occurring in the meninges, central nervous system, bones of the skull, and most commonly in the middle ear and mastoid region.
ConceptsDisease or Syndrome (T047)
ICD9385.30
EnglishCholesteatoma, Cholesteatomas, Epidermoid cholesteatoma
Spanishcolesteatoma, colesteatoma epidermoide
Parent ConceptsDisorder of middle ear (C0271428), Keratosis (C0022593), Cholesteatoma of middle ear / mastoid (C0008374), Non-Neoplastic Head and Neck Disorder (C1335014), Ear Diseases (C0013447), Hyperkeratosis (C0870082)
SourcesAOD, COSTAR, CSP, ICD9CM, LCH, MSH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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