[Cholesteatoma of the ear]

Cholesteatoma of the ear is characterized by the presence of a keratinizing squamous epithelium in the cavities of the middle ear. The epithelium invades the ear either by direct migration or by retraction of the eardrum. Owing to is potentials for migration, desquamation, bone erosion and infection, it is for most of the complications of chronic otitis and fully justifies the adjective "dangerous" applied to chronic cholesteatomatous otitis. The clinical diagnosis rests on microscope otoscopy. Audiometry informs on the degree of hearing loss and on the state of the contralateral ear. Standard radiography and computerized tomography of the petrous bone evaluate the extent of the lesion. Treatment is purely surgical: it consists of excision of the entire epithelium that has entered the middle ear and, secondarily, conservation or improvement of hearing. Whatever the surgical technique used, the frequency of recurrences calls for long-term follow-up.