otoscopic exam: how does it present?
A cholesteatoma consists of squamous epithelium that is trapped within the skull base and that can erode and destroy important structures within the temporal bone.
The hallmark symptom of a cholesteatoma is a painless otorrhea, either unremitting or frequently recurrent.
Squamous epithelium trapped within the temporal bone (ie, middle ear or mastoid) can expand only at the expense of the bone that surrounds and contains it. Consequently, a growing cholesteatoma can erode and destroy important structures within the temporal bone
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