Cholesteatoma – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:24 am Published by

A cholesteatoma is a cyst composed of keratinizing squamous epithelium occurring in the middle ear, mastoid and temporal bone. It can be congenital or acquired, in which case it is usually a consequence of otitis media or chronic eustachian tube dysfunction.

Sn. & Sx.:

  • Fever
  • Progressive conductive hearing loss
  • Dizziness
  • Otalgia
  • Otorrhea
  • Tinnitus
  • Aural fullness
  • History of otitis media, ventilation tubes

dDx.:

  • Cerumen impaction
  • Otitis (AOE, AOM, effusion)
  • Foreign body

Sequelae:

  • Hearing loss
  • Ossicular erosion
  • Inner ear erosion
  • Temporal bone infection (mastoiditis, petrositis)
  • Facial palsy, paralysis
  • Meningitis
  • Intracranial abscess

Work up:

  • Otoscopic exam (retraction pocket in the tympanic membrane, tympanic membrane perforation, visible polyps/granulation tissue)
  • Imaging (CT scan)

Tx.:

  • Surgical resection

Categorised in:

This post was written by Omar Rifai