clinical features
Last reviewed 01/2018
The hallmarks of a cholesteatoma are:
- smelly (faecal) discharge
and chronic drainage
- often presents as chronic otorrhea unresponsive to antibiotic therapy (1)
- hearing loss
- in 90 percent of patients there is conductive hearing loss caused by ossicular erosion (2)
Other symptoms depend on the extent of local expansion. Possible associated clinical features include:
- vertigo
- headache
- facial nerve palsy - caused by pressure
- cerebral abscess formation
- cerebellopontine angle syndrome
Otoscopy commonly shows, either:
- pearly, white, glistening debris occupying a perforation in the tympanic membrane - usually the pars flaccida
- crusting in the uppermost part of the ear drum - the attic - beneath which lies a cholesteatoma
Tuning fork tests usually show a conductive hearing loss.
Reference: