Cholesteatoma (of middle ear): Pathogenesis and clinical findings

 • Congenital trapping of keratinizing epithelium in middle ear

 • Portion of eardrum retracts into middle ear

 • Ingrowth of keratinizing epithelium in middle ear

=> Cholesteatoma - Destructive growth of keratinizing squamous epithelium in the middle ear

Signs / Symptoms / Complications

 • Visualization of mass in middle ear on otoscopy

 • Conductive hearing loss

 • Erosion of external auditory canal (EAC)

 • Aural Polyp secondary to inflammation

 • Acute otitis media 

 • Coalescent Mastoiditis

 • Chronic otitis media

 • Facial nerve paralysis

 • Intracranial Infection (parenchymal abscess, meningitis, subdural abscess)

 • Conductive hearing loss

 • Labyrinthine fistula

 • Vertigo

 • Sensorineural hearing loss



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