Ear disorders: The Daily PANCE Blueprint

Home Ear disorders: The Daily PANCE Blueprint

Ear disorders: The Daily PANCE Blueprint

A 10-year-old old with a history of recurrent otitis media presents to the clinic due to a “bad smell” from his right ear. His mom notices he can’t hear as well out of that ear. On physical exam, you notice a pearly mass behind the tympanic membrane. What is the most likely diagnosis?

A. Paraganglioma of the middle ear
B. Middle ear adenoma
C. Cholesteatoma
D. Acoustic neuroma
E. Tympanic membrane perforation

Answer and topic summary

The answer is C. Cholesteatoma

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.

View blueprint lesson

Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint EENT ⇒ Ear Disorders (PEARLS) ⇒ Middle ear (PEARLS) => Cholesteatoma

Also covered as part of the Family Medicine EOR topic list

Sign up for the ENTIRE Blueprint Daily Email Series (500 days and counting! 😀)

Sign Up
X