Highlights & Basics
- Cholesteatoma is an accumulation of squamous epithelium and keratin debris that usually involves the middle ear and mastoid.
- Although benign, it may enlarge and invade adjacent bone.
- Often presents with a malodorous ear discharge with associated hearing loss.
- Diagnosis is clinical based on history and otoscopic findings. CT scan of the temporal bone, provides lesion definition and extent.
- Treatment is surgical removal. Adjunctive topical antimicrobial treatment may help reduce acute symptoms preoperatively.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
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Citations
Kuo CL, Shiao AS, Yung M, et al. Updates and knowledge gaps in cholesteatoma research. Biomed Res Int. 2015;2015:854024.[Abstract][Full Text]
Castle JT. Cholesteatoma pearls: practical points and update. Head Neck Pathol. 2018 Sep;12(3):419-29.[Abstract][Full Text]
Isaacson G. Diagnosis of pediatric cholesteatoma. Pediatrics. 2007 Sep;120(3):603-8.[Abstract]
Bhutta MF, Williamson IG, Sudhoff HH. Cholesteatoma. BMJ. 2011 Mar 3;342:d1088.[Abstract]
Ayache D, Darrouzet V, Dubrulle F, et al. Imaging of non-operated cholesteatoma: clinical practice guidelines. Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Jun;129(3):148-52.[Abstract]
American College of Radiology. ACR appropriateness criteria: hearing loss and/or vertigo. 2018 [internet publication].[Full Text]
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5. Yung M, Tono T, Olszewska E, et al. EAONO/JOS joint consensus statements on the definitions, classification and staging of middle ear cholesteatoma. J Int Adv Otol. 2017 Apr;13(1):1-8.[Abstract]
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13. Bonnard Å, Engmér Berglin C, Wincent J, et al. The risk of cholesteatoma in individuals with first-degree relatives surgically treated for the disease. JAMA Otolaryngol Head Neck Surg. 2023 May 1;149(5):390-6.[Abstract][Full Text]
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19. Chole RA, Faddis BT. Evidence for microbial biofilms in cholesteatomas. Arch Otolaryngol Head Neck Surg. 2002 Oct;128(10):1129-33.[Abstract][Full Text]
20. Wang EW, Jung JY, Pashia ME, et al. Otopathogenic Pseudomonas aeruginosa strains as competent biofilm formers. Arch Otolaryngol Head Neck Surg. 2005 Nov;131(11):983-9.[Abstract][Full Text]
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22. Bhutta MF, Williamson IG, Sudhoff HH. Cholesteatoma. BMJ. 2011 Mar 3;342:d1088.[Abstract]
23. Dement'eva NF, Shilenkov AA, Kozlov VS. Otoendoscopy for the diagnosis of chronic middle ear diseases. Vestn Otorinolaringol. 2010;(1):71-5.[Abstract]
24. Meyer A, Bouchetemblé P, Costentin B, et al. Lateral semicircular canal fistula in cholesteatoma: diagnosis and management. Eur Arch Otorhinolaryngol. 2016 Aug;273(8):2055-63.[Abstract]
25. Ayache D, Darrouzet V, Dubrulle F, et al. Imaging of non-operated cholesteatoma: clinical practice guidelines. Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Jun;129(3):148-52.[Abstract]
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45. Tomlin J, Chang D, McCutcheon B, et al. Surgical technique and recurrence in cholesteatoma: a meta-analysis. Audiol Neurootol. 2013;18(3):135-42.[Abstract]
46. Jindal M, Riskalla A, Jiang D, et al. A systematic review of diffusion-weighted magnetic resonance imaging in the assessment of postoperative cholesteatoma. Otol Neurotol. 2011 Oct;32(8):1243-9.[Abstract]
47. Schwartz KM, Lane JI, Bolster BD Jr, et al. The utility of diffusion-weighted imaging for cholesteatoma evaluation. AJNR Am J Neuroradiol. 2011 Mar;32(3):430-6.[Abstract][Full Text]
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49. Clark MP, Westerberg BD, Fenton DM. The ongoing dilemma of residual cholesteatoma detection: are current magnetic resonance imaging techniques good enough? J Laryngol Otol. 2010 Dec;124(12):1300-4.[Abstract]
50. National Institute for Health and Care Excellence. Otitis media with effusion in under 12s. Aug 2023 [internet publication].[Full Text]
51. Roger G, Denoyelle F, Chauvin P, et al. Predictive risk factors of residual cholesteatoma in children: a study of 256 cases. Am J Otol. 1997 Sep;18(5):550-8.[Abstract]
52. Copeland BJ, Buchman CA. Management of labyrinthine fistulae in chronic ear surgery. Am J Otolaryngol. 2003 Jan-Feb;24(1):51-60.[Abstract]
53. Westerhout SF, Straatman LV, Dankbaar JW, et al. Labyrinthine fistulas: surgical outcomes and an additional diagnostic strategy. Am J Otolaryngol. 2022 May-Jun;43(3):103441.[Abstract][Full Text]
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60. Karimi-Yazdi A, Amiri M, Rabiei S, et al. Topical application of mitomycin C in the treatment of granulation tissue after canal wall down mastoidectomy. Iran J Otorhinolaryngol. 2013 Spring;25(71):85-90.[Abstract][Full Text]
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