Richard Henry Wiggins MD, Presenter: Consultant, Amirsys, Inc Stockholder, Amirsys, Inc

1) To review the causes and types of temporal bone cholesteatomas. 2) To develop an understanding of the potential complications of cholesteatomas. 3) To identify and accurately report the important clinical findings and potential complications of temporal bone cholesteatomas.

A cholesteatoma is a mass of skin growth in an abnormal location. This lesion is usually considered benign and consists of keratinizing debris, which can be found within the temporal bone, and which pathologically are similar to epidermoid tumors. These lesions are commonly divided into acquired and congenital cholesteatomas. The acquired cholesteatomas can be further divided into the pars tensa, and pars flaccida types. They may also be separated by location into cholesteatomas of the middle ear, petrous apex, and mastoid process. These lesions can grow, leading to destruction of the surrounding important anatomic landscape of the temporal bone, leading to several complications which can be identified on imaging studies. These complications include the destruction of the ossicles, leading to hearing loss, as well as labyrinthine fistula formation into the inner ear, automastoidectomy, as well as intracranial complications, such as meningitis, venous thrombosis, and abscess formation.

Wiggins, R, Cholesteatoma: Diagnosis and Complications.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5000148.html