The chronic middle ear disease known as cholesteatoma is a relatively uncommon and severe disorder. Cholesteatoma may develop at any time or it may be present at birth.The congenital form, which is developed at birth is much more uncommon than the acquired form. "In rare instances, a cholesteatoma may form due to skin tissue that is trapped behind the tympanic membrane during fetal development" (Pediatric). When this is the case, there is no account of a hole in the eardrum. Nevertheless, the cholesteatoma can be as widespread as the acquired form. "These cholesteatomas usually represent small “Pearls” or cysts that are directly attached to the inner surface of the tympanic membrane or one of the ear bones" (Pediatric).
The other kind of cholesteatoma, which is more frequently seen, develops differently."Acquired cholesteatoma may be caused by a persistent narrowing of the Eustachian tube, eventually pulling the upper part of the eardrum back and forming a sac in the middle ear" (Turkington). However this is not the only possible cause for acquired cholesteatoma."The acquired form may also occur because of a tiny hole in the eardrum that allows skin cells of the external ear canal to move into the middle ear" (Turkington). A puncture in the tympanic membrane like that one would ordinarily mend without any surgical procedures done. The difference in this situation, however, is that instead of restoring itself in the typical way, the skin of the eardrum extends through the hole into the middle ear. At that point, "If infection is present, the skin will continue to grow into the middle ear and will become a tumor of the ear…"(Levenson).
At this point, the cholesteatoma can begin to expand itself and impairs its surroundings. The cyst as time goes by gets larger and puts pressure on the structures it comes into the contact with damaging them. Since the tumor develops in a s…

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