Cholesteatoma refers to a sac-like collection of keratinizing stratified squamous epithelium in the middle ear. It may develop as a complication of a number of conditions affecting the middle ear, usually as a result of a marginal perforation of the tympanic membrane.


Risk factors for cholesteatoma:

(1) congenital (from embryonic rests of squamous epithelium, associated with an intact tympanic membrane)

(2) trauma (below)

(3) associated with chronic otitis media (most common causes)

(4) associated with eustachian tube dysfunction, especially in children with a cleft palate


Causes of traumatic cholesteatoma:

(1) barotrauma

(2) iatrogenic injury associated with middle ear surgery

(3) mechanical perforation of the tympanic membrane

(4) longitudinal fracture of the pyramid


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