cholesteatoma

Etiology

• eustachian tube dysfunction

Pathology

• epidermoid cyst arising in CNS;
  • occur throughout the neuraxis, most common sites
    • skull & cerebellopontine angle
• eustachian tube dysfunction resulting in tympanic membrane retraction
  • inflammation in a pocket behind the retracted membrane
    • epithelial debris accumulates in this pocket with continued inflammation
    • may eventually erode into middle ear or mastoid
• collection of keratinized, desquamated epithelial cells in the middle ear or mastoid
• does not contain cholesterol or lipids
• not a neoplasm.

Clinical manifestations

• chronic ear pain
• discharge into the external auditory canal
• unilateral hearing loss

Diagnostic procedures

• otoscopy
  • opaque, perforated tympanic membrane
    • drainage into the external auditory canal
    • white mass visible in the middle ear canal
  • without perforation of tympanic membrane
    • cholesteatoma may appear as a subtle whitish discoloration behind an otherwise normal tympanic membrane.

Management

• ENT referral

More general terms

• epidermoid cyst (wen, infundibular cyst)
• CNS cyst

Patient information

cholesteatoma patient information