Introduction

Cholesteatoma is a non-cancerous growth of squamous epithelium that is 'trapped' within the skull base causing local destruction. It is most common in patients aged 10-20 years.

Epidemiology

  • Incidence: 10.00 cases per 100,000 person-years
  • Peak incidence: 6-15 years
  • Sex ratio: 1:1
Condition Relative
incidence
Otitis externa50.00
Acute otitis media25.00
Cholesteatoma1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Aetiology

Being born with a cleft palate increases the risk of cholesteatoma around 100 fold.

Clinical features

Main features

Other features are determined by local invasion:

Otoscopy
  • 'attic crust' - seen in the uppermost part of the ear drum

Management

Management
  • patients are referred to ENT for consideration of surgical removal