Cholesteatoma: Difference between revisions
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**Their accumulation results in a slowly expanding mass | **Their accumulation results in a slowly expanding mass | ||
**Sac of dead skin cells growing in middle ear on out of surface of TM | **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]]) | *Can destroy ossicles and expand into mastoid (rarely, intracranially causing [[brain abscess]] or [[meningitis]]) | ||
*Often chronically infected with intermittent drainage | *Often chronically infected with intermittent drainage | ||
Revision as of 20:39, 30 September 2019
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
- 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.