Chronic Suppurative Otitis Media
Terms in this set (31)
What is cholesteatoma?
Presence of keratinizing squamous cell epithelium in middle ear or mastoid
What is the other name for cholesteatoma?
What are the different theories of genesis of cholesteatoma?
How is cholesteatoma classified?
Where do congenital cholesteatoma arise from?
Epidermal cell rests in middle ear cleft or temporal bone
Where are the most common places of involvement of cholesteatoma?
How does primary acquired cholesteatoma occur?
Invagination of pars flaccida,
Basal cell proliferation,
How does secondary acquired cholesteatoma occur?
Migration of meatal epithelium through marginal perforation,
What is chronic suppurative otitis media?
Long standing infection of a part or whole of the middle ear cleft characterized by ear discharge and a permanent perforation
When does a perforation become permanent?
Edges covered by squamous epithelium,
Doesn't heal spontaneously
What points differentiate tubotympanic from atticoantral?
Why is there persistent otorrhoea?
Sensitization of middle ear mucosa to aeroallergens
Most commonly, necrosis is seen in which part?
Long process of incus
What are the pathological changes in tubotympanic type?
Middle ear mucosal changes
Ossicular chain necrosis
What is tympanosclerosis?
Chalky white deposits,
Hyalinization, calcification of subepithelial connective tissue
What are the common causative agents of tubotympanic type?
What is healed chronic otitis media?
Perforation healed by two layers
Atrophic, easily retracted
What are the clinical features of tubotympanic type?
Middle ear mucosa
Why do some people hear better in the presence of discharge?
Round window shielding effect
How does mixed hearing loss occur?
Absorption of toxins from round and oval windows
What are the investigations done in tubotympanic type?
Culture and sensitivity of ear discharge,
Mastoid X-ray, CT scan temporal bone
What are the pathological processes in atticoantral type?
Osteitis and granulation tissue
What are the symptoms of atticoantral type of CSOM?
What are the signs of atticoantral type of CSOM?
Attic, posterosuperior marginal perforation,
Why should total cessation of discharge from a previously discharging ear be taken seriously?
Maybe sealed by crusted discharge, inflamed mucosa, polyp
What is cholesteatoma hearer?
Cholesteatoma bridges the gap caused by destroyed ossicles,
What do we see in an X-ray mastoids?
Low lying dura,
Anteposed sigmoid sinus
What are the features indicating complications?
Listless child refusing to take feeds
Fever, nausea, vomiting,
Irritability and neck rigidity,
Abscess round the ear
What are the treatments of atticoantral type of CSOM?
What are the differences between canal wall up and canal wall down procedures?
Recurrence and residual cholesteatoma,
Second look surgery,
What are the chemical cautery materials used?
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