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Cholesteatoma

  • By admin
  • November 29, 2016
  • Comments Off on Cholesteatoma

Disclosure: Received honoraria from Alcon Labs for consulting; Received honoraria from Advanced Bionics for board membership; Received honoraria from Cochlear Corp for board membership; Received travel grants from Med El Corp for consulting. These include advancing age, structural defects, infection, certain neurological and/or genetic conditions and trauma to the ear or skull1,2. Sometimes there is a problem in this process (hole in the eardrum is seen as a barrier, the fact that the negative pressure in the middle ear, chronic or recurrent middle ear infection) can cause for developing of cholesteatoma. Cholesteatomeas may develop anywhere within pneumatized portions of the temporal bone, with the most frequent locations being the middle ear and the mastoid. Placement of ear tubes (PETubes) is a common outpatient procedure for children. As the cholesteatoma enlarges, it can cause a fullness and pressure in the ear, along with hearing loss and tinnitus. The skin over the outer surface of the eardrum can start to grow through the perforation and into the middle ear.

Coincident loss of hearing is often present. Bone erosion can cause the infection to spread into the surrounding areas, including the inner ear and brain. The risks of surgery are similar to those of leaving the cholesteatoma untreated, such as hearing loss, tinnitus and vertigo, but generally the benefits of removing the cholesteatoma far outweigh the risks. Large cholesteatomas usually require surgical treatment to protect the patient from complications. In one instance the authors observed a relapse of cholesteatoma in a patient operated by the so-called “closed method”. These tests are performed to determine the hearing level remaining in the ear and the extent of destruction caused by the cholesteatoma. Surgery is performed under general anesthesia.

The primary purpose of the surgery is to remove the cholesteatoma and infection, and achieve an infection-free, dry ear. Hearing preservation or restoration is the second goal of surgery. Surgery usually requires a mastoidectomy procedure.

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