Cholesteatoma

Description:

Cholesteatoma — the tumorous education developing often against the background of a chronic purulent inflammation of a middle ear and representing the accumulation of a keratin, crystals of cholesterol and a desquamated keratosic epithelium surrounded with a cover. Putting the constant pressure upon surrounding bone walls, the cholesteatoma destroys a bone tissue.

Cholesteatoma symptoms:

Most of patients complain of the stupid, aching, holding apart, pressing or shooting ear pain, a headache; there can be a dizziness caused by a labyrinthitis. Allocations from an ear more often happen scanty to an unpleasant putrefactive smell. In purulent separated it is possible to find whitish curdled lumps. At an aggravation the cholesteatoma of an ear is exposed to purulent disintegration that quite often leads to developing of meningitis, paresis of a facial nerve, abscess of a brain or a cerebellum, a labyrinthitis, otogenic sepsis, subperiosteal abscess (it is frequent with periodically closed fistula).

Cholesteatoma reasons:

Depending on an etiology of a cholesteatoma divide on:

    * Cholesteatoma secondary (new lat. cholesteatoma sccundarium) — a cholesteatoma false, secondary. Develops against the background of a chronic inflammation of a middle ear or okolonosovy bosoms, as a result of mechanical transfer of the multilayer flat epithelium producing a keratin in zones where this fabric is absent.
    * Cholesteatoma inborn (new lat. cholesteatoma congenitum) — a cholesteatoma true, primary. Is a consequence of the wrong formation of an ectodermal rudiment at early stages of an embryogenesis. Inborn cases of a cholesteatoma meet extremely seldom.
    * Cholesteatoma false (new lat. cholesteatoma spurium, Xing. the pseudo-cholesteatoma) — arises as a result of an inflammation or an injury (mechanical damage or a barotrauma).

It is necessary to differentiate a cholesteatoma of a middle ear and a cholesteatoma of a spinal cord post-puncture (new lat. cholesteatoma medullae spinalis post punctionem) which arises owing to a drift of cells of an epithelium in covers of a spinal cord at a spinal puncture. Also the cholesteatoma of a genyantrum which can have the dontogenous nature meets.

Treatment of the Cholesteatoma:

Conservative treatment is shown only in the presence of the small cholesteatoma which is localized in the supratympanic space available to washing through a special tube with the curved end. For washing it is possible to use spirit solution of boric acid, proteolytic enzymes, etc. The termination of suppuration and the subsequent epithelization of supratympanic deepening in many cases allow to avoid an operative measure. At unsuccessfulness of conservative treatment make radical a middle ear operation. The forecast at timely diagnosis and treatment favorable.

Prevention consists in the prevention of otitis, and at its development — in timely and rational treatment of inflammatory process that is especially important at children's age.