4 Interesting Facts of Cholesteatoma

  1. Abnormal nonmalignant tumor that develops as a result of migration of keratinized hyperproliferative squamous epithelium into the middle ear space; acquired cholesteatoma is a complication of repeated bouts of otitis media or chronic otitis media; congenital cases are rare
  2. Presents with malodorous otorrhea, ear discomfort, hearing loss, mass in the middle ear space, and sometimes otalgia; on examination, cholesteatoma appears as a whitish rounded mass visible deep behind the tympanic membrane, usually anteriorly or anterosuperiorly 
  3. Many complications from excessive growth can result if not treated (eg, bony erosion, permanent hearing loss, perilymphatic fistula, facial nerve paralysis, intracranial infectious complications)
  4. Differentiate from otitis externa by clinical presentation and clinical course; differentiate disease by imaging if the diagnosis remains in question (CT is preferred over MRI) 

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