Cholesteatoma--diagnosing the unsafe ear.

BACKGROUND

Cholesteatoma represents the most common destructive disease of the ear, affecting the adult and paediatric population alike.

OBJECTIVE

This article describes the pathogenesis of cholesteatoma and provides a guide to the examination and management of this common disease.

DISCUSSION: Despite advances in surgery and imaging, the diagnosis of cholesteatoma is often delayed. A favourable outcome following treatment of a cholesteatoma rests in part on an early diagnosis, and in reducing significant complications and associated morbidity. Primary care physicians should maintain a high index of suspicion for the presence of cholesteatoma, awareness of otoscopic findings and promptly refer for investigations and management.