In Nepal: In this young patient, the chronic infection of the ear (giant cholestatoma) led to a life threatening complication (fistula).
Additional image: operation
A cholestatoma is a chronic-festering inflammation of the middle ear with bone destruction, which is caused by an ingrowth of squamous epithelium from the external auditory canal into the middle ear, in most cases.
In the healthy ear, the squamous epithelium is completely separated from the tympanum by mucosal epithelium of the middle ear. When this barrier is absent, cells of the squamous epithelium can grow into the tympanic cavity. This causes an epidermis-like spread of keratinising squamous epithelium into the middle ear cavities. By a disrupted efflux of secretions and a bacterial superinfection – often with Pseudomonas aeruginosa – the ingrowth of squamous epithelium supports a chronic inflammation. This indlammation can spread to osseous parts of the middle ear and inner ear, which are successively destroyed by this.
Source: Surgery Dr. Eberle