Cholesteatoma and the Destruction of Middle Ear and Mastoid Cavities in Ottorhoea

Objective: To determine the relative frequency of various parts of temporal bone eroded by cholesteatoma. Place and duration of study: This was a combined study conducted in the ENT Departments of Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, and Lady Reading Hospital Peshawar. The study took place over a period of 5 years from January1, 2007 to December 31, 2011. Sample size: The study included 70 cases of chronic suppurative otitis media with cholesteatoma. Study design: It was a descriptive study using the non probability convenience sampling technique. Methodology: This was a combined study conducted in the ENT Departments of Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar and Lady Reading Hospital Peshawar from January1, 2007 to December 31, 2011. Informed consent was obtained before including patients in the study. The various parts of temporal bone eroded by cholesteatoma were studied in patients who underwent radical and / or modified radical mastoidectomy for chronic suppurative otitis media with cholesteatoma. The frequency of damage to the ossicular chain and other bones was determined. Results: A total of 70 cases were included in the study. The ages of the patients ranged from 8 to 48 years. The male to female ratio was 3:1. All the patients had chronic suppurative otitis media with cholesteatoma and underwent radical and / or modified radical mastoidectomy. The commonest type of bony erosion was damage to the ossicular chain (92.85%) followed by erosion of the lateral attic wall (54.28%). Conclusion Cholesteatoma has the ability to erode bony structures which may lead to deafness, disability and potentially life threatening intracranial complications. Therefore it is important that the examiner is aware of its possibility in patients presenting with otorrhea, the types of bone damage it may cause and it’s potential for producing serious consequences.