1. Cholesteatoma A cholesteatoma is a benign growth of skin in an abnormal location such as the middle ear or petrous apex. http://www.earsite.com/tumors/cholesteatoma.html

Cholesteatoma The initial signs of a cholesteatoma are drainage from the ear canal and hearing loss. A cholesteatoma is a benign growth of skin in an abnormal location such as the middle ear or petrous apex. The latter is an area of bone located deep to the inner ear. Normally, squamous epithelium or skin lines the entire ear canal and the outer surface of the eardrum. The outermost layer of skin is actually composed of dead cells which are constantly being sloughed off and expelled with earwax. A major component of these dead cells is a protein called keratin. Normal Cholesteatoma The problem occurs when the dead cells accumulate in the middle ear and can not be expelled. Typically an infection occurs with intermittent drainage from the ear. As this ball of dead cells acumulates it produces enzymes which cause the destruction of bone. Complications from untreated cholesteatoma Erosion of the ossicles or bones behind the eardrum can lead to a conductive hearing loss. The bone over the facial nerve can also be destroyed and a facial paralysis can result. The inner ear is composed of a bony labyrinth which can also be partially destroyed. This can lead to a sensorineural hearing loss and dizziness. The infection can also spread into the veins carrying blood from the brain to the heart. This large vein called the lateral venous sinus can obstruct and cause excessive fluid to accumulate within and around the brain leading to a condition called hydrocephalus. The infection can also spread to the covering of the brain and cause meningitis. In rare circumstances, a brain abscess can result.

2. Cholesteatoma Website cholesteatoma Website. THIS SITE REMAINS EXCLUSIVE TO THE DISCUSSION OF cholesteatoma. http://www.cholesteatoma.org/

3. AAO-HNS - Cholesteatoma Am. Academy of OtolaryngologyHead and Neck Surgery discusses this condition characterized by abnormal skin growth behind the middle ear and answers common questions. http://www.entnet.org/cholesteatoma.html

4. Cholesteatoma And Ear Surgery, 6th International Conference, Chairman : Jacques cholesteatoma and Ear Surgery 2000 6th international conference - Chairman Jacques MAGNAN - JUNE 29th to JULY 2nd, 2000 CANNES - French Riviera http://www.chole2000.org/

5. Ear Surgery Information Center-Cholesteatoma A look at the symptoms, possible complications and treatment of this disorder.Category Health Conditions and Diseases Ear cholesteatoma......cholesteatoma. If infection is present, the skin will continue to grow into themiddle ear and will become a tumor of the ear termed a cholesteatoma. http://www.earsurgery.org/cholest.html

Ear Surgery Information Center CHOLESTEATOMA by Mark J. Levenson, MD, FACS Cholesteatoma Mastoid Tympano mastoidectomy Congenital cholesteatoma A perforation of the ear drum will generally heal without surgery. In some cases, however, instead of normally healing, the skin of the ear drum can grow through the hole into the middle ear. If infection is present, the skin will continue to grow into the middle ear and will become a tumor of the ear termed a cholesteatoma. Cholesteatomas are NOT a form of cancer. They are benign tumors. As they grow, they can look like an onion peel of white skin formed into a ball. They can destroy the bones of hearing as they grow, especially when the ear is infected or if water gets into the middle ear with other infections. Symptoms of cholesteatoma include hearing loss and recurring discharge from the ear. Pus or unpleasant smelling fluids coming from the ear are common. A surgical microscope is necessary to make a proper inspection and cleansing of the condition, especially when there is infection. A history of recurring ear infections after colds, or the entrance of water into the ear from swimming, require the ear to be examined regularly for this condition.

6. Ear Surgery Information Center-Cholesteatoma Surgery Most cholesteatomas require that an incision be made behind the ear to expose thetumor adequately. The cholesteatoma is completely removed microscopically. http://www.earsurgery.org/surgcho.html

Ear Surgery Information Center THE SURGERY Some cholesteatomas which are very small can be removed through the ear canal. Most cholesteatomas require that an incision be made behind the ear to expose the tumor adequately. The cholesteatoma is completely removed microscopically. Hearing reconstruction is often delayed because it is necessary to rebuild the bones of hearing at a future date. In more extensive cholesteatomas, the tumor may have eroded through the bony wall which separates the middle ear from the mastoid. This may require a more radical operation, removing the wall separating the middle ear from the mastoid. The result is a so-called open cavity which requires life-long follow-up. In the past, ear surgeons believed that this operation had to be performed in ALL cholesteatomas involving the mastoid. However, today, most ear surgeons agree that the open cavity, or radical mastoid operation should be reserved for only the most invasive and destructive cholesteatomas. In less extensive cholesteatomas, especially when infection is well controlled before surgery, an intact canal wall operation is the favored procedure. This operation preserves the wall between the middle ear and mastoid. The principal advantages of the intact canal wall operation are a more normal canal and ear drum, and a greater possibility of hearing restoration. In addition, most patients with the intact canal wall operation can allow water in the ear.

7. Procedure Two cholesteatoma. As the eustachian tube becomes dysfunctional, negative pressureis generated in the middle ear and the eardrum starts to retract inward. http://www.earsite.com/tumors/procedure_two.html

Cholesteatoma As the eustachian tube becomes dysfunctional, negative pressure is generated in the middle ear and the eardrum starts to retract inward. An accumulation of dead skin within a retracted pocket of the eardrum can erode adjacent bone and lead to a draining ear and hearing loss. Back To Cholestatoma Home

8. Cholesteatoma A cholesteatoma is a skin growth that occurs in an abnormal location, themiddle ear behind the eardrum. cholesteatoma What Is a cholesteatoma? http://www.entnet.org/healthinfo/ears/cholesteatoma.cfm

ENT Link ENT Health Information Ears Cholesteatoma Cholesteatoma What Is a Cholesteatoma? A cholesteatoma is a skin growth that occurs in an abnormal location, the middle ear behind the eardrum. It is usually due to repeated infection, which causes an ingrowth of the skin of the eardrum. Cholesteatomas often take the form of a cyst or pouch that sheds layers of old skin that builds up inside the ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear. Hearing loss, dizziness, and facial muscle paralysis are rare but can result from continued cholesteatoma growth. How Does It Occur? A cholesteatoma usually occurs because of poor eustachian tube function as well as infection in the middle ear. The eustachian tube conveys air from the back of the nose into the middle ear to equalize ear pressure ("clear the ears"). When the eustachian tubes work poorly perhaps due to allergy, a cold or sinusitis, the air in the middle ear is absorbed by the body, and a partial vacuum results in the ear. The vacuum pressure sucks in a pouch or sac by stretching the eardrum, especially areas weakened by previous infections. This sac often becomes a cholesteatoma. A rare congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones. However, the type of cholesteatoma associated with ear infections is most common. What Are the Symptoms?

9. Cholesteatoma: A Serious Ear Condition A look at what this is, why it is in the ear, how it occurred there, when should something be done Category Health Conditions and Diseases Ear cholesteatoma......cholesteatoma A Serious Ear Condition. This site maintainted by Peter J. Casano,MD, (601) 9325244. Press to return to home page. What Is a cholesteatoma? http://www.sinuscarecenter.com/choleaao.html

Cholesteatoma: A Serious Ear Condition This brochure is a copy of an American Academy of Otolaryngology - Head and Neck Surgery Public Service Brochure. This site maintainted by Peter J. Casano, M.D., What Is a Cholesteatoma? A cholesteatoma is a skin growth that occurs in an abnormal location, the middle ear behind the eardrum. It is usually due to repeated infection, which causes an ingrowth of the skin of the eardrum. Cholesteatomas often take the form of a cyst or pouch that sheds layers of old skin that builds up inside the ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear. Hearing loss, dizziness, and facial muscle paralysis are rare but can result from continued cholesteatoma growth. How Does It Occur? A cholesteatoma usually occurs because of poor eustachian tube function as well as infection in the middle ear. The eustachian tube conveys air from the back of the nose into the middle ear to equalize ear pressure ("clear the ears"). When the eustachian tubes work poorly perhaps due to allergy, a cold or sinusitis, the air in the middle ear is absorbed by the body, and a partial vacuum results in the ear. The vacuum pressure sucks in a pouch or sac by stretching the eardrum, especially areas weakened by previous infections. This sac often becomes a cholesteatoma. A rare congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones. However, the type of cholesteatoma associated with ear infections is most common.

10. PathFinders Cholesteatoma Page cholesteatoma Web Site. You are visitor number 139939. cholesteatoma is aformation, often considered a tumor, that grows within the inner ear. http://www.cholesteatoma.org/scripts/earsurge.asp

Created June 10th, 1997 Last Updated January 27th, 2003 Cholesteatoma Web Site You are visitor number See the WebMaster Note! Cholesteatoma is a formation, often considered a tumor, that grows within the inner ear. Although in almost all cases it is not cancerous, but rather an accumulation of proteins (keratin) that forms behind the eardrum. It often invades and deteriorates bones behind the eardrum which relays hearing to the brain. The condition is frequent but most experiences provide evidence that poor euchstation tube drainage associated with allergies and ear infections are the culprit to this disease. We appreciate, and accept all inquiries about the removal of cholesteatomas. We are extremely interested in others willing to educate the rest of us on problems and/or successes with their surgeries and general care after surgery, as we have questions as well! To prevent web-bots (automated programs that search websites and create links) from linking to your testimonies, I have instituted a system where each testimony is dynamically created from programming code. Ownership of the testimonies remains with the poster. It can be altered or deleted at the posters request. I do proofread, and respond to most of the testimonies and remove proper names of the doctors and/or care facilities where warranted. Frankly, you are great at adhereing to the guidelines! A plain and simple Thank you!

11. Grand Rounds Archives PEDIATRIC cholesteatoma A. Paul Vastola, MD October 7, 1993. The term cholesteatomais actually a misnomer coined by Johannes Muller in 1838. http://www.bcm.tmc.edu/oto/grand/10793.html

Grand Rounds Archives The information contained within the Grand Rounds Archive is intended for use by doctors and other health care professionals. These documents were prepared by resident physicians for presentation and discussion at a conference held at The Baylor College of Medicine in Houston, Texas. No guarantees are made with respect to accuracy or timeliness of this material. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature. PEDIATRIC CHOLESTEATOMA A. Paul Vastola, MD October 7, 1993 The term cholesteatoma is actually a misnomer coined by Johannes Muller in 1838. He described "a layered pearly tumor of fat which was distinguished from other fat tumors by the presence of biliary fat or cholestrin that is interspersed among sheets of polyhedral cells." Aural cholesteatomas are best thought of as skin growing in the middle ear space. Cholesteatomas actually do not contain fat but are composed of an outer matrix which surrounds layers of desquamated epithelium. The matrix is comprised of fully differentiated keratinizing squamous epithelium resting on a collagenous perimatrix. Various theories have been advanced to account for the destructive bone resorption seen commonly with these lesions. These include activation of osteoclastic bone destruction, mechanical pressure necrosis and bone degradation by enzymes such as collagenases and lysozymes.

12. Cholesteatoma And Chronic Mastoiditis cholesteatoma and Chronic Mastoiditis. The cholesteatoma. cholesteatoma isan epithelial cyst (made from the tissue and cells that make skin). http://www.nycornell.org/ent/cholesteatoma.html

Cholesteatoma and Chronic Mastoiditis The middle ear and the mastoid are directly connected to each other and are normally filled with air. Air enters the middle ear via the eustachian tube which opens into the naspharynx (deep portion of the nasal chamber). Recurrent middle ear infections may be due to poor function of the eustachian tube. Although most middle ear infections resolve, some recur or persist. Those chronic infections may lead to damage of the tympanic membrane (ear drum) that can result in a perforation or, in some cases to recurrent infections of the mastoid, or even cholesteatoma. Cholesteatoma is an epithelial cyst (made from the tissue and cells that make skin). Technically, it is not a tumor, but it grows independently. Cholesteatomas grow slowly, yet are able to erode and destroy bone in their path. Most commonly bone destruction is manifest as erosion of the ossicles (the vibrating bones of hearing), but cholesteatoma can erode into the inner ear, leading to nerve deafness and vertigo, or can erode into the intracranial cavity leading to infection around or inside the brain. Cholesteatoma can erode the bone surrounding and protecting the facial nerve, and can lead to facial weakness, or in severe cases paralysis. Cholesteatoma is treated by microsurgery. Several different types and degrees of tymanomastoidectomy surgery exist for cholesteatoma. The appropriate surgery is selected on the basis of the size and location of the cholesteatoma. Reconstruction of damaged ossicles is also possible, but may require additional surgery depending on the findings at the initial surgery. Cholesteatoma surgery can be lengthy, since it requires meticulous microdissection, but success rates for control of cholesteatoma are high and risks of surgery are low.

13. Cholesteatoma cholesteatoma links dedicated to informing patients, students, andhearing healthcare providers. Contains summary of at that site. http://www.audiologynet.com/cholesteatoma.html

AudiologyNet Audiology Information for the Masses Cholesteatoma Cholesteatoma....Ear Surgery Information Center Good Site with excellent information!! Cholesteatoma....Sixth International Conference Basic web site that has very nice answers about several common questions that are usually associated with cholesteatoma's. Pediatric Cholesteatoma....Baylor College of Medicine Interesting information about cholesteatomas that occur in childhood. Not much information in general is written on the subject. Makes for good reading. Cholesteatoma: A Serious Ear Condition The web site has general patient information. It is very easy to understand. Cholesteatoma....AllHealth Concise and easy to understand article that has a lot of useful information for patients, students, and the general public. CT Appearances of External Ear Canal Cholesteatoma This is an advanced web site that looks at a rare type of cholesteatomas. It is a very interesting web site. It has images of the CT scans, but a computer with high resolution is recommended to view them.

14. EMedicine - Middle Ear, Cholesteatoma : Article By Peter S Roland, MD Middle Ear, cholesteatoma cholesteatoma has been recognized for decades as adestructive lesion of the skull base that can erode and destroy important http://www.emedicine.com/ent/topic220.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Otolaryngology and Facial Plastic Surgery Middle Ear Middle Ear, Cholesteatoma Last Updated: July 17, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: keratoma AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Indications Relevant Anatomy And Contraindications ... Bibliography Author: Peter S Roland, MD , Chair, Professor, Department of Otolaryngology, University of Texas Southwestern Medical Center Peter S Roland, MD, is a member of the following medical societies: Alpha Omega Alpha , American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery American Otological Society , and Texas Medical Association Editor(s): Jack A Shohet, MD , Director of Neurotology-Skull Base Surgery, Assistant Clinical Professor, Department of Otolaryngology-Head and Neck Surgery, University of California at Irvine Medical Center; Francisco Talavera, PharmD, PhD

15. EMedicine - Cholesteatoma : Article By Peter S Roland, MD cholesteatoma For decades, cholesteatoma has been recognized as a destructive lesionof the skull base that can erode and destroy important structures within http://www.emedicine.com/ped/topic384.htm

(advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Pediatrics Otolaryngology Cholesteatoma Last Updated: July 11, 2001 Rate this Article Email to a Colleague Synonyms and related keywords: keratoma AUTHOR INFORMATION Section 1 of 11 Author Information Introduction Clinical Differentials ... Bibliography Author: Peter S Roland, MD , Chair, Professor, Department of Otolaryngology, University of Texas Southwestern Medical Center Peter S Roland, MD, is a member of the following medical societies: Alpha Omega Alpha , American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery American Otological Society , and Texas Medical Association Editor(s): Orval Brown, MD , Director of Otolaryngology Clinic, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center at Dallas; Robert Konop, PharmD , Clinical Assistant Professor, Department of Pharmacy, Section of Clinical Pharmacology, University of Minnesota;

16. Cholesteatoma And Ear Surgery 2000 - Navigation cholesteatoma and Ear Surgery 2000 6th international conference - Chairman Jacques MAGNAN - JUNE 29th to JULY 2nd, 2000 CANNES - French Riviera. Contact, http://www.chole2000.org/index_menu.htm

17. MEDLINEplus Medical Encyclopedia: Cholesteatoma cholesteatoma. the problem. Treatment Return to top The only knowntreatment is surgical removal of the cholesteatoma. Surgery may http://www.nlm.nih.gov/medlineplus/ency/article/001050.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Cholesteatoma Contents of this page: Illustrations Definition Causes, incidence, and risk factors Symptoms ... Prevention Illustrations Tympanic membrane Definition Return to top A type of cyst located in the middle ear. Causes, incidence, and risk factors Return to top Cholesteatoma can be a congenital defect, but it more commonly occurs as a complication of chronic ear infection . Long-term inflammation and malfunction of the eustachian tube leads to chronic negative pressure in the middle ear. This pulls a portion of the eardrum (tympanic membrane) inward, creating a sac or cyst that fills with old skin cells and other debris. The cyst becomes chronically infected. The cyst typically continues to fill with debris over time and may erode the mastoid bone and the bones of the middle ear. Symptoms Return to top drainage from the ear , usually chronic hearing loss in one ear pain or numbness in the ear or around the ear dizziness Signs and tests Return to top Inspection of the ear may show a pocket or perforation (opening) in the eardrum, often with drainage. The deposit of old skin cells may be visible with an

18. Cholesteatoma cholesteatoma. cholesteatoma A cholesteatoma is a greasylooking mass or accumulationof debris that is seen in a retraction pocket or perforation. http://www.aap.org/otitismedia/www/vc/ear/rvw/rvw20.cfm

Pneumatic Otoscopy Review Course Cholesteatoma 1.Tools 2.Landmarks 3.Views 4.Light Reflex ... AOM Case Studies Cholesteatoma A cholesteatoma is a greasy-looking mass or accumulation of debris that is seen in a retraction pocket or perforation. It often presents as chronic otorrhea unresponsive to antibiotic therapy. The diagram below shows how a retraction pocket can enlarge and accumulate debris to form an acquired cholesteatoma. Cholesteatomas also may be congenital. Cholesteatoma 20 of 21

19. Chemodectoma cholesteatoma, Book, Management Surgical excision of cholesteatoma;Second look procedure may be scheduled at 6 months. Complications http://www.fpnotebook.com/ENT53.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Otolaryngology Hematology and Oncology Ear Disease ... Ear Tumor Chemodectoma Cholesteatoma Acoustic Neuroma Laryngeal Disease Laryngeal Neoplasm ... Tongue Carcinoma Assorted Pages Neck Masses in Adults Neck Masses in Children Branchial Cleft Cyst Cystic Hygroma ... Submandibular Exam Chemodectoma Glomus tumor Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Otolaryngology Index Allergy Dermatology Ear Disease Examination Hearing Hematology and Oncology Infectious Disease Laboratory Laryngeal Disease General Lip Throat Disease Neurology Nasal Disease Obstetrics Pharmacology Procedure Radiology Salivary Sinus Disease Sports Medicine Symptom Evaluation Tongue Vertigo Page Hematology and Oncology Index Ear Tumor Ear Tumor Chemodectoma Ear Tumor Cholesteatoma Ear Tumor Neuroma Larynx Tumor Lip Tumor Mouth Tumor Mouth Tumor SCC Neck Mass Adult Neck Mass Children Neck Mass Branchial Cleft Neck Mass Hygroma Neck Mass Thyroglossal Cyst Nose Tumor Salivary Tumor Tongue Carcinoma Pathophysiology Arises from glomus bodies Tympanic membrane invasion follows Hearing loss May involve

20. Cholesteatoma Resources Home Welcome to cholesteatoma Resources. The cholesteatoma Resources web site offersand provides information of a general nature about cholesteatoma. http://cholesteatoma.netfirms.com/

This site is hosted by Netfirms Web Hosting Welcome to Cholesteatoma Resources . This site has been developed to provide easy to understand, up to date information to individuals that have been diagnosed with cholesteatoma or their family members. I started this site after my son, Vinny, was diagnosed with cholesteatoma in October 2001 at the age of six after countless visits to the pediatrician's office for ear infections since infancy. As soon as the surgeon told us what he had and the complications it could cause I tried to learn as much about it as possible. During the learning process I joined a YahooGroup for Cholesteatoma patients and their families and also visited www.cholesteatoma.org . This is when I discovered that it was not as 'rare' as I first assumed and that there are many people out there in the same situation as Vinny - many worse. My first reaction was to see a lawyer about the pediatricians that never made the diagnosis in six years, but after more research and time spent with the YahooGroup I decided to try to turn this into something positive. This web site is a start, and an organization to promote awareness is the goal. I believe that the word cholesteatoma can be something that every patient, every parent, and every doctor will know in the near future with your help Lisa Mazzarell Vinny's Family l-r: Dad (Sam), Mom (Lisa), Vinny, Sister (Lindsay)

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