Cholesteatoma: Difference between revisions
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==Background== | ==Background== | ||
*Commonly secondary to Eustachian tube dysfunction, which retracts TM | |||
*A retraction pocket forms and desquamating skin cells are trapped | |||
**Usually in "attic" involving pars flaccida | |||
**Their accumulation results in a slowly expanding mass | |||
**Sac of dead skin cells growing in middle ear on out of surface of TM | |||
*Can destroy ossicles and expand into mastoid (rarely, intracranially causing [[brain abscess]] or [[meningitis]]) | |||
*Often chronically infected with intermittent drainage | |||
==Clinical Features== | ==Clinical Features== | ||
*Conductive [[hearing loss]] | |||
*May be associated with imbalance and facial weakness | |||
*Retraction of TM around ossicles | |||
*Formation of cholesteatoma that can retract into the attic of the middle ear | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 8: | Line 18: | ||
==Evaluation== | ==Evaluation== | ||
*Clinical diagnosis | |||
*Consider CT for examination of ossicle encasement | |||
==Management== | ==Management== | ||
*ENT referral | |||
==Disposition== | ==Disposition== | ||
*Outpatient, unless complicated intracranial process | |||
*Many patients require second-look surgical procedure after first | |||
==See Also== | ==See Also== | ||
| Line 20: | Line 32: | ||
==References== | ==References== | ||
*Schraff SA and Strasnick B. Pediatric cholesteatoma: A retrospective review. International Journal of Pediatric Otorhinolaryngology. Volume 70, Issue 3, March 2006, Pages 385-393. | |||
<references/> | <references/> | ||
[[Category:ENT]] | [[Category:ENT]] | ||
Latest revision as of 15:02, 10 February 2021
Background
- Commonly secondary to Eustachian tube dysfunction, which retracts TM
- A retraction pocket forms and desquamating skin cells are trapped
- Usually in "attic" involving pars flaccida
- Their accumulation results in a slowly expanding mass
- Sac of dead skin cells growing in middle ear on out of surface of TM
- Can destroy ossicles and expand into mastoid (rarely, intracranially causing brain abscess or meningitis)
- Often chronically infected with intermittent drainage
Clinical Features
- Conductive hearing loss
- May be associated with imbalance and facial weakness
- Retraction of TM around ossicles
- Formation of cholesteatoma that can retract into the attic of the middle ear
Differential Diagnosis
Ear Diagnoses
External
- Auricular hematoma
- Auricular perichondritis
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
Internal
- Acute otitis media
- Chronic otitis media
- Mastoiditis
Inner/vestibular
Evaluation
- Clinical diagnosis
- Consider CT for examination of ossicle encasement
Management
- ENT referral
Disposition
- Outpatient, unless complicated intracranial process
- Many patients require second-look surgical procedure after first
See Also
References
- Schraff SA and Strasnick B. Pediatric cholesteatoma: A retrospective review. International Journal of Pediatric Otorhinolaryngology. Volume 70, Issue 3, March 2006, Pages 385-393.