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Cholesteatoma: recognition and management.

A cholesteatoma is an abnormal collection of viable and desquamated squamous epithelium in the middle ear or mastoid air spaces. Early recognition and treatment are important. Unlike chronic middle ear effusion or recurrent otitis media, a cholesteatoma inexorably destroys the middle and inner ear. Delayed diagnosis increases the chance of otologic complications, such as permanent hearing loss, permanent balance dysfunction, infection and facial paralysis. Initial management includes careful cleansing of the ear and topical and oral antibiotics. Definitive treatment requires surgical excision.