The presence of granulation tissue visible by otoscopy which denotes an inflammatory reaction against bone in the form of osteitis. Cholesteatomas of the temporal bone may be congenital or acquired. Acquired cholesteatomas are the consequence of OME or AOM or both. The diagnosis of aural cholesteatoma is made on otoscopic examination or surgical exploration. Computed tomography or magnetic resonance imaging may suggest the presence of cholesteatomas within the temporal bone and may be used to complement the clinical examination.
Symptoms are variable.
Some cholesteatomas are asymptomatic. The most common presenting symptom is aural discharge, especially when there is superimposed infection. Foul smelling otorrhea suggests infection with anaerobic bacteria which is common. Conductive hearing loss in next most common. The otoscopic appearance of an aural cholesteatoma is also variable.