are skin or stratified keratinising squamous epithelium growing in the middle ear (1)
they are a greasy-looking mass or accumulation of debris that is seen in a retraction pocket or perforation.(2)
they often take the form of a cyst or pouch that sheds layers of old skin (3)
divided into two types (1):
congenital
presents as a pearly white mass located behind an intact tympanic membrane
acquired.
results from a retracted or perforated tympanic membrane with an ingrowth of epithelium
aetiology :
the cause is unknown
it may result from blockage of the Eustachian tube producing a chronic negative pressure in the middle ear which would cause the tympanic membrane to be sucked inwards as a retraction pocket
usually, the pars flaccida is indrawn but any thin part of the pars tensa may be involved.
the pockets gradually expand as the skin dequamates. Invariably, they become infected and smelly
a cholesteatoma is potentially very dangerous because local expansion may result in damage to adjacent vital structures such as dura, lateral sinus, facial nerve and the semicircular canal
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