Cholesteatoma and Types of CSOM MCQs

In above all the condition we see Hearing loss except in acute otitis media .In Acute otitis media patient present with Ear ache . The most common cause of hearing loss in children less than 12 years is Serous otitis media. Reference : Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Chapter name: Disorders of Middle Ear, Page number: 75

Prussak's space is the most common site of cholesteatoma formation in middle ear. It lies between the pars flaccida and the neck of malleus. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 80, 549. Reference: Scott Brown's Otolaryngology, Head and Neck Surgery, 8 th edition, Volume 2, Page - 1191.

Spread of infection from the middle ear to petrous bone is called Petrositis or Gradinego syndrome. This is a triad of Ear discharge Deep seated ear or Retro-orbital pain(CN V involvement) Diplopia(CN VI involvement - Lateral rectus palsy) It is a complication of CSOM. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 95.

Mechanism of bone erosion in Cholesteatoma: Inflammatory Osteitis Enzymatic theory-Bone destryoing Enzyme Reference : Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8th Edition, Chapter name: Cholesteatoma and Chronic Otitis Media, Page number: 80, 81

Sinus tympani Sinus tympani is a deep recess on medial wall of middle ear. It is a hidden area and most common site of residual cholesteatoma after mastoid surgery. Boundaries of facial Recess Superior - Ponticulus Inferior - Subiculum Lateral - Limited by vertical segment of facial nerve. Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 87.

After a blast injury, a cholesteatoma may arise behind a spontaneously healed tympanic membrane. Reference: Diseases of Ear, Nose, AND Throat by PL Dhingra

A posterosuperior marginal perforation if allowed to progress will lead to secondary acquired cholesteatoma(In these cases, there is already a pre-existing perforation in pars tensa). Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery by P L Dhingra, 8 th Edition, Page - 80.

Tubercular otitis media is characterized by multiple perforations in the tympanic membrane, pale granulations , and foul-smelling ear discharge . Painful otorrhea is not a typical feature of tubercular otitis media. In laryngeal Tb there will be painful phonation. Other options and why they are wrong: B. Multiple perforations: Multiple perforations in the tympanic membrane are a characteristic feature of tubercular otitis media due to the destructive nature of the disease. C. Pale granulations: Tubercular otitis media is associated with pale or edematous granulations due to the chronic inflammatory process. D. Foul-smelling ear discharge: Foul-smelling or purulent ear discharge is commonly observed in tubercular otitis media due to the chronic infection.