H71.13

Clinical Causes: Repeated middle ear infections (otitis media) Eustachian tube dysfunction, leading to improper ventilation of the middle ear Chronic ear infections causing damage to the ear structures Previous ear surgery or trauma Congenital factors, such as developmental abnormalities Poor drainage of ear fluids, leading to skin accumulation

Key Symptoms: Persistent hearing loss, often bilateral (affecting both ears) Ear fullness or pressure sensation Drainage from the ears, which may be foul-smelling Occasional ear pain or discomfort Tinnitus, or ringing in the ears Balance issues or vertigo in some cases Visible signs of ear swelling or abnormal growth

Diagnosis Path: Otoscopy, to visually inspect the ear canal and tympanic membrane for abnormal growths Audiometric tests to assess hearing loss Imaging studies like CT scans of the temporal bones, which provide detailed views of the middle ear structures Possible biopsy or surgical exploration if the diagnosis remains uncertain

Treatment Protocols: Surgical Removal: The main treatment involves surgery to excise the cholesteatoma and repair any damaged structures in the middle ear. Mastoidectomy: In advanced cases, part of the mastoid bone may be removed to eradicate the disease and prevent recurrence. Reconstruction: Following removal, procedures such as tympanoplasty may be performed to restore the eardrum and middle ear bones. Management of Infections: Antibiotics or ear drops may be prescribed to treat ongoing infections or inflammation. Regular follow-up: Postoperative monitoring to detect any signs of recurrence or complications.