Cholesteatoma – Long case ENT OSCE
May 30, 2021
Estimated reading time: 6 min
Cholesteatoma:
- Cystlike, “epidermal inclusion cysts” expansile lesions of the temporal
bone lined by stratified squamous epithelium “ matrix” that contain
desquamated keratin. - Presence of keratinising squamous epitheliumin in the middle ear or
mastoid (Skin in the wrong place) .
Cholesteatoma is known to contain all the layers of skin epithelium. The basal layer (germinating layer) is present on the outer surface of cholesteatoma sac in contact with the walls of the middle ear cleft.
- Normally, middle ear cleft is lined by different types of epithelium in
different regions.
o Ciliated columnar in the anterior and inferior part.
o Cuboidal in the middle part
o Pavement-like in the attic.
o No where lined by keratinising squamous epithelium. - The term cholesteatoma is a misnomer:
o It neither contains cholesterol crystals nor is it a tumour to merit the suffix “oma”.
o The term has been retained because of its wider usage.
o It has also been named Epidermosis or Keratoma.
Contents
- Matrix:
o Made up of keratinising squamous epithelium resting on a thin stroma
of fibrous tissues. - Keratin mass:
o Central white mass consisting of keratin debris produced by the matrix.
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