H95.02

Clinical Causes: Incomplete removal of cholesteatoma tissue during initial surgery Re-entry of skin cells into the postmastoidectomy cavity Chronic ear infections leading to tissue proliferation Altered ear anatomy post-surgery that promotes keratin buildup Genetic predisposition to abnormal epithelial growth

Key Symptoms: Persistent or recurrent, foul-smelling ear discharge (otorrhea) Hearing loss or worsening hearing over time A feeling of fullness or pressure in the affected ear Tinnitus (ringing or buzzing in the ear) Occasional ear pain or discomfort Dizziness or balance issues in some cases Recurrent infections despite treatment

Diagnosis Path: Diagnosis is typically made through a combination of clinical examination and imaging studies. An otolaryngologist will perform an otoscopic examination to visualize the postmastoidectomy cavity for signs of cholesteatoma growth, such as abnormal tissue or debris. Imaging techniques like high-resolution computed tomography (CT) scans of the temporal bone help assess the extent of the lesion and evaluate any involvement of surrounding structures. Occasionally, surgery may be necessary to confirm the diagnosis and fully remove the cholesteatoma tissue.

Treatment Protocols: Treatment primarily involves surgical intervention to remove the recurrent cholesteatoma and prevent further complications. The options include: - **Surgical removal (cholesteatoma surgery)**, which may involve re-operation on the mastoid or middle ear to excise the abnormal tissue. - **Postoperative care** with antibiotics to manage and prevent infection. - **Regular follow-up examinations** to monitor for recurrence. - **Hearing rehabilitation** may be considered if hearing loss persists after treatment. In some cases, additional procedures like canal wall reconstruction may be required to optimize ear function and reduce the risk of future cholesteatoma formation.