Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- perda auditiva
- otorreia resistente à antibioticoterapia
- crosta no ático na bolsa de retração
- massa branca atrás da membrana timpânica intacta
Other diagnostic factors
- zumbido
- otalgia
- paladar alterado
- tontura
- fraqueza do nervo facial
Risk factors
- doença da orelha média
- disfunção da tuba auditiva
- cirurgia otológica
- lesão traumática por explosão na orelha
- anomalias congênitas
- história familiar
Diagnostic tests
1st tests to order
- audiometria de tons puros
- Tomografia computadorizada (TC) dos ossos temporais petrosos
Tests to consider
- teste de fístula
- RNM da cabeça e dos ossos petrosos temporais
- cultura bacteriana
Treatment algorithm
todos os pacientes
Contributors
Authors
Susan A. Douglas, MBBS (Hons) UWI, FRCSEd, FRCS (ORL-HNS)
Consultant Otolaryngologist and Otologist
Rotherham NHS Foundation Trust
Rotherham
UK
Disclosures
SAD declares that she has no competing interests.
Peer reviewers
Cliff Megerian, MD
Professor and Vice Chairman of Otolaryngology
Case Western Reserve University School of Medicine
Cleveland
OH
Disclosures
CM is an author of a reference cited in this topic.
Iain Swan, MD, FRCS
Senior Lecturer in Otolaryngology
Honorary Consultant Otolaryngologist
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
IS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Kuo CL, Shiao AS, Yung M, et al. Updates and knowledge gaps in cholesteatoma research. Biomed Res Int. 2015;2015:854024.Full text Abstract
Castle JT. Cholesteatoma pearls: practical points and update. Head Neck Pathol. 2018 Sep;12(3):419-29.Full text Abstract
Isaacson G. Diagnosis of pediatric cholesteatoma. Pediatrics. 2007 Sep;120(3):603-8. Abstract
Bhutta MF, Williamson IG, Sudhoff HH. Cholesteatoma. BMJ. 2011 Mar 3;342:d1088. Abstract
Ayache D, Darrouzet V, Dubrulle F, et al. Imaging of non-operated cholesteatoma: clinical practice guidelines. Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Jun;129(3):148-52. Abstract
American College of Radiology. ACR appropriateness criteria: hearing loss and/or vertigo. 2018 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- otite média crônica supurativa
- Otite externa
- Otite externa necrosante benigna
More DifferentialsGuidelines
- ACR appropriateness criteria: tinnitus
- Otitis media with effusion in under 12s
More GuidelinesPatient information
Infecção da orelha média
Infecção da orelha externa
More Patient informationVideos
Como examinar a orelha
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