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 (C)</p> Signup and view all the answers

What is the recommended treatment for cholesteatoma?

<p>Surgery (D)</p> Signup and view all the answers

Which of the following is a potential complication of cholesteatoma?

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

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

<p>Blood test (A)</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 (D)</p> Signup and view all the answers

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

<p>Meningitis (C)</p> Signup and view all the answers

Which of the following is the cardinal symptom of cholesteatoma?

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

What is the most common cause of acquired cholesteatoma?

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

What is the potential consequence of untreated cholesteatoma?

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

Which of the following is a diagnostic procedure for cholesteatoma?

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

When is surgery indicated for cholesteatoma?

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

What is the recommended surgical treatment for cholesteatoma?

<p>Tympanomastoidectomy (C)</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 (B)</p> Signup and view all the answers

When is MRI indicated in the evaluation of cholesteatoma?

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

Which of the following is a clinical feature of cholesteatoma?

<p>Tinnitus (B)</p> Signup and view all the answers

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

<p>White (D)</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 (A)</p> Signup and view all the answers

What are the cardinal symptoms of cholesteatoma?

<p>Painless otorrhea and progressive hearing loss (C)</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 (B)</p> Signup and view all the answers

What can happen if a cholesteatoma is left untreated?

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

What is the surgical treatment for cholesteatoma?

<p>Tympanomastoidectomy (A)</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 (B)</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 (A)</p> Signup and view all the answers

What triggers an inflammatory response in cholesteatoma?

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

What is the most common cause of acquired cholesteatoma?

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

When is surgery indicated for cholesteatoma?

<p>Always, regardless of symptoms (B)</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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