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 externa | 50.00 |
| Acute otitis media | 25.00 |
| Cholesteatoma | 1 |
| <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
- foul-smelling, non-resolving discharge
- hearing loss
Other features are determined by local invasion:
- vertigo
- facial nerve palsy
- cerebellopontine angle syndrome
Otoscopy
- 'attic crust' - seen in the uppermost part of the ear drum
Management
Management
- patients are referred to ENT for consideration of surgical removal