Cholesteatoma: The Daily PANCE Blueprint
Which of the following best describes the pathophysiology of an acquired cholesteatoma?
A. Fungal invasion of the inner ear structures
B. Autoimmune destruction of cochlear hair cells
C. Malignant infiltration into the middle and inner ear
D. Fluid accumulation behind the tympanic membrane
E. Abnormal growth of squamous epithelium in the middle ear due to chronic inflammation
Answer and topic summary
The answer is E. Abnormal growth of squamous epithelium in the middle ear due to chronic inflammation
A cholesteatoma can be acquired (from eustachian tube dysfunction or chronic otitis media) or congenital. It occurs due to abnormal accumulation and growth of the squamous epithelium found in the middle ear or mastoid process. Clinical features include otorrhea (foul-smelling discharge) and conductive hearing loss. On physical exam you may note a white or pearly mass (but sometimes brown) behind the tympanic membrane. Imaging can be ordered to assess bone destruction. Management is surgical excision.
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