Cholesteatoma

Cholesteatoma (cholesteatoma) is a false tumor of fat cells, cholesterol, fatty acids and keratinized epithelia. It has enzymes on the surface → it destroys the surroundings. It is most often found in the middle ear or in the area of ​​the mastoid process.

It grows locally destructively. It oppresses the surrounding structures and causes their atrophy to necrosis (destroys the auditory ossicles and the surrounding bone).

Etiology
The formation of cholesteatoma is interpreted as:
 * Migration of the epidermis into the middle ear after perforation of the eardrum,
 * a diverticulum of the epidermal layer of the tympanic membrane,
 * true epidermoid from fragments of ectoderm during development of the ear canal.

It can be congenital or acquired (more common).
 * Secondary infection is quite common (Pseudomonas aeruginosa).

Clinical picture

 * Inflammation (there is also a non-inflammatory form of genuine cholesteatoma) – chronic ear infections;
 * There may be a perforation of the eardrum,
 * ear discharge,
 * pain;
 * ± symptoms of spread to the inner ear, meninges, venous drainage;
 * conductive hearing loss, deafness, balance disorders, dizziness.

Treatment

 * Surgical – removal of cholesteatoma.

Complications

 * Untreated, it causes chronic inflammation of the middle ear, damage to the facial nerve, meningitis, inflammation of intracranial veins, deafness, …

Prognosis
Recurrences are possible after surgical removal.

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