CHOLESTEATOMA

BY FAIZZUL
HANIFF
 DEFINITION
Destructive and expanding growth consisting of keratinizing squamous
epithelium in the middle ear and/or mastoid part of the temporal bone.

not classified as either tumors or cancers, they can still cause

significant problems because of their erosive and expansile properties
resulting in the destruction of the bones of the middle ear (ossicles),

possible spread through the base of the skull into the brain.
can result in chronically draining ears.
 Cause
Cholesteatomas occur in two basic
classifications:
1.Acquired cholesteatomas,
more common,: are usually caused by
pathological alteration of the ear drum
leading to accumulation of keratin within
the middle ear.
2.Congenital cholesteatomas are usually
middle ear epidermal cysts that are
identified deep within an intact ear drum.
 Sign and Symptom
majority (98%) of patients with cholesteatoma
have ear discharge or hearing loss or both in the
affected ear.
Other less common symptoms (all less than
15%) of cholesteatoma may include:
balance disruption
Tinnitus
ear ache
headaches
bleeding from the ear
 Sign and Symptom
If untreated, a cholesteatoma can eat into
the three small bones located in the
middle ear (the malleus, incus and stapes,
collectively called ossicles) which can
result in nerve deterioration, deafness,
imbalance and vertigo
 Investigation
1.Audiogram - may show a conductive hearing
loss

2.bacterial culture - positive for micro-organisms

3.CT scan of the petrous temporal bones -

opacification of the middle ear or mastoid;
erosion of the scutum, ossicular chain, labyrinth,
facial canal, tegmen, or bony capsule of the
sigmoid sinus
 Treatment
surgically remove the growth
This typically involves some form of
mastoidectomy which may or may
not involve removing the posterior
ear canal wall and the ossicles.
MASTOIDECTOMY
 TYMPANOSTOMY

Ventilation tube placement may prevent the

formation of secondary cholesteatomas by
ensuring long-term continuous middle ear
ventilation