Clinical Findings and Diagnosis of Cholesteatoma

Aim: To differentiate cholesteatoma from non cholesteatoma (control) CSOM on simple clinical grounds for its early detection and management. Methods: A series of 156 patients (aged 5-64-years of either sex) having atticoantral (unsafe) ear disease, including 94 patients with cholesteatoma CSOM and 62 patients of CSOM without cholesteatoma (controls) were inducted in the study. The clinical sign and symptoms, EUM and peroperative findings of both groups were recorded, compared and analyzed on SPSS12. Results: Patients had almost same age and gender composition in either group. No significant social or hereditary predisposition observed. Cholesteatoma patients had a significantly higher incidence of pars flaccida and attic perforation (94.72%-isolated 82%) vs. 82.24%-isolated 40.24%) with associated shed out Keratin in external meatus in 73.24% and 6.44% in the cholesteatoma and control groups. Cholesteatoma patients had a higher incidence (29.68%) of previous middle ear surgery than the control patients (22.54%).aural bleeding was reported by 6(9.66%) controlled cases vs 3(3.18%) cholesteatoma cases. Conclusion: No specific clinical indicators recorded that could distinguish cholesteatoma from control CSOM. Cholesteatoma was not evident till surgical exploration in around 24% of cases. Therefore surgical exploration appears mandatory for final diagnosis of cholesteatoma.