Clinical practice cholesteatoma diagnosing the unsafe ear 634 reprinted from australian family physician vol.
Cholesteatoma attic retraction.
1 attic retraction pocket cholesteatoma is clearly visualized white arrow.
A primary acquired cholesteatoma results from tympanic membrane retraction.
When findings of the 13 year olds and 13 year olds were combined the commonest site of cholesteatoma was the attic 66 of 128 which is 51 6 followed by extension into mastoid 54 of 128 which is 43 2 subsequently followed by extension into the sinus tympani 33 of 128 which is 25 8.
Invagination of the tympanic membrane of the attic to form retraction pockets to be filled with desquamated epithelium and keratin to form cholesteatoma.
As this process continues the lateral wall of the epitympanum the scutum is slowly eroded producing a defect in the lateral wall of the.
There has been significant bone erosion of the ear canal wall above the eardrum.
Cholesteatoma is an accumulation of squamous epithelium and keratin debris that usually involves the middle ear and mastoid.
Skin material often accumulates in this pocket and becomes infected causing drainage and potential severe complications.
The pars flaccida is not in contact with the neck of the malleus.
This is the most common and widely considered as the main reason for cholesteatoma.
Clinical presentation the vast majority of acquired cholesteatomas develo.
Diagnosis is clinical based on histor.
Retraction pockets a retraction pocket is an invagination of the tympanic membrane.
Often there is an accumulation of squamous debris within the pocket.
Eustachian tube theory.
5 ruedi s theory.
The basal cells of germinal layer of skin proliferate under the influence of infection and lay down keratinising squamous epithelium.
An attic cholesteatoma is defined as an epidermoid cyst found in the attic.
This is differentiated from an infected retraction pocket of the pars tensa or a retraction pocket cholesteatoma.
The negative middle ear pressure which is the cause of retraction pocket toss classified attic retraction pockets into 4 grades.
The classic case develops from progressively deeper medial retraction of the pars flaccida into the epitympanum attic.
Acquired cholesteatomas makeup 98 of all middle ear cholesteatomas and are almost always closely related to the tympanic membrane from which most are thought to arise.
Stratified squamous epithelium may also be present in the middle ear as other clinical or pathological entities such as metaplastic islands of the mucosa.
Invagination of tympanic membrane from the attic or part of pars tensa in the form of retraction pockets lead to the formation of cholesteatoma.
