Cholesteatoma
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Questions and Answers

Which of the following is a clinical feature of cholesteatoma?

  • Painful otorrhea
  • Conductive hearing loss (correct)
  • Asymptomatic
  • Normal otoscopic findings

    • What is the typical otoscopic finding in primary acquired cholesteatoma?

  • Normal tympanic membrane
  • Brown, irregular mass
  • White or pearly mass behind the tympanic membrane
  • Retraction pocket with squamous epithelium and debris (correct)

    • What imaging modality is recommended to assess the degree of bone destruction in cholesteatoma?

  • X-ray of the mastoid process
  • CT scan of the temporal bone (correct)
  • MRI of the temporal bone
  • Ultrasound of the ear

    • When is MRI indicated in the evaluation of cholesteatoma?

    <p>To assess intracranial extension</p> Signup and view all the answers

    What is the recommended treatment for cholesteatoma?

    <p>Surgery</p> Signup and view all the answers

    Which of the following is a potential complication of cholesteatoma?

    <p>Destruction of ear ossicles</p> Signup and view all the answers

    What is the surgical procedure used to excise cholesteatoma and create a dry ear?

    <p>Canal wall-down mastoidectomy</p> Signup and view all the answers

    Which of the following is NOT a diagnostic modality for cholesteatoma?

    <p>Blood test</p> Signup and view all the answers

    What is the typical color of a congenital or secondary acquired cholesteatoma mass behind the tympanic membrane?

    <p>White</p> Signup and view all the answers

    What is the potential consequence of erosion of the temporal bone in cholesteatoma?

    <p>Meningitis</p> Signup and view all the answers

    Which of the following is the cardinal symptom of cholesteatoma?

    <p>Progressive hearing loss</p> Signup and view all the answers

    What is the most common cause of acquired cholesteatoma?

    <p>Eustachian tube dysfunction</p> Signup and view all the answers

    What is the potential consequence of untreated cholesteatoma?

    <p>Temporal bone erosion</p> Signup and view all the answers

    Which of the following is a diagnostic procedure for cholesteatoma?

    <p>Mastoid process x-rays</p> Signup and view all the answers

    When is surgery indicated for cholesteatoma?

    <p>Always, regardless of symptoms</p> Signup and view all the answers

    What is the recommended surgical treatment for cholesteatoma?

    <p>Tympanomastoidectomy</p> Signup and view all the answers

    Which imaging modality is recommended to assess the degree of bone destruction in cholesteatoma?

    <p>Temporal bone CT scan</p> Signup and view all the answers

    When is MRI indicated in the evaluation of cholesteatoma?

    <p>To confirm the presence of cholesteatoma</p> Signup and view all the answers

    Which of the following is a clinical feature of cholesteatoma?

    <p>Tinnitus</p> Signup and view all the answers

    What is the typical color of a cholesteatoma mass behind the tympanic membrane?

    <p>White</p> Signup and view all the answers

    Which structure can be destroyed by the inflammatory response triggered by the presence of abnormal epithelium in cholesteatoma?

    <p>Middle ear mucosa</p> Signup and view all the answers

    What are the cardinal symptoms of cholesteatoma?

    <p>Painless otorrhea and progressive hearing loss</p> Signup and view all the answers

    Which diagnostic procedures are important in the evaluation of cholesteatoma?

    <p>Temporal bone CT scans, tympanometry, and audiometric tests</p> Signup and view all the answers

    What can happen if a cholesteatoma is left untreated?

    <p>Facial nerve palsy and sigmoid sinus thrombosis</p> Signup and view all the answers

    What is the surgical treatment for cholesteatoma?

    <p>Tympanomastoidectomy</p> Signup and view all the answers

    What is the pathophysiology of acquired cholesteatoma?

    <p>Epithelium migrates inwards through a perforation in the tympanic membrane</p> Signup and view all the answers

    What is the difference between congenital and acquired cholesteatoma?

    <p>Congenital cholesteatoma is present at birth, while acquired cholesteatoma develops later in life</p> Signup and view all the answers

    What triggers an inflammatory response in cholesteatoma?

    <p>Presence of abnormal epithelium in the tympanic membrane</p> Signup and view all the answers

    What is the most common cause of acquired cholesteatoma?

    <p>Chronic otitis media</p> Signup and view all the answers

    When is surgery indicated for cholesteatoma?

    <p>Always, regardless of symptoms</p> Signup and view all the answers

    Cholesteatoma may be ______

    <p>asymptomatic</p> Signup and view all the answers

    Painless ______ from the affected ear

    <p>otorrhea</p> Signup and view all the answers

    Conductive hearing ______ occurs late in primary cholesteatoma

    <p>loss</p> Signup and view all the answers

    Primary acquired cholesteatoma presents as a retraction pocket with ______ mass

    <p>brown, irregular</p> Signup and view all the answers

    Congenital and secondary acquired cholesteatoma presents as a ______ mass behind the tympanic membrane

    <p>white or pearly</p> Signup and view all the answers

    Imaging is used to assess the degree of ______ in cholesteatoma

    <p>bone destruction</p> Signup and view all the answers

    MRI is indicated if ______ extension is suspected

    <p>intracranial</p> Signup and view all the answers

    Surgery is always ______ for cholesteatoma

    <p>indicated</p> Signup and view all the answers

    Excision of the cholesteatoma is performed using canal wall-up or canal wall-down ______

    <p>mastoidectomy</p> Signup and view all the answers

    Complications of cholesteatoma include destruction of ear ______

    <p>ossicles</p> Signup and view all the answers

    Cholesteatoma is a special form of chronic otitis media in which keratinizing squamous ______ grows from the tympanic membrane or the auditory canal into the middle ear mucosa or mastoid

    <p>epithelium</p> Signup and view all the answers

    The presence of abnormal ______ in an abnormal location triggers an inflammatory response that can destroy surrounding structures such as the ossicles

    <p>epithelium</p> Signup and view all the answers

    Cholesteatomas may be ______ or acquired later in life

    <p>congenital</p> Signup and view all the answers

    Acquired cholesteatomas are usually associated with chronic middle ear ______

    <p>infection</p> Signup and view all the answers

    Cardinal symptoms are painless otorrhea and progressive ______ loss

    <p>hearing</p> Signup and view all the answers

    Important diagnostic procedures include mastoid process x-rays, temporal bone CT scans, and ______ tests

    <p>audiometric</p> Signup and view all the answers

    Left untreated, erosion of the surrounding bone by a cholesteatoma can lead to facial nerve palsy, extradural abscess, and/or sigmoid ______ thrombosis

    <p>sinus</p> Signup and view all the answers

    Therefore, even if a cholesteatoma is asymptomatic, ______ is always indicated

    <p>surgery</p> Signup and view all the answers

    Surgical treatment involves tympanomastoidectomy to excise the cholesteatoma, followed by repair of the damaged middle ear ______

    <p>structures</p> Signup and view all the answers

    Congenital cholesteatoma is present at birth and consists of embryonic nests of ______ cells that remain in the middle ear

    <p>epidermal</p> Signup and view all the answers

    Acquired cholesteatoma can be primary, which is caused by eustachian tube dysfunction, or ______, which occurs when epithelium migrates inwards through a perforation in the tympanic membrane

    <p>secondary</p> Signup and view all the answers

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