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Perlak is a tumor that occurs in the middle ear. It can be both congenital and acquired, appearing during the patient's life. The problem with these changes is that they can develop without discomfort, which increases the risk of complications. What symptoms suggest cholesteatoma, what are the risks of having a pearl tumor in the ear, and what are the treatment options for cholesteatoma?

Perlak(Latincholesteatoma ,pearly tumor ) is a lumpy lesion that occurs maybe in the middle ear. This creation was named for the first time in 1838 - the name cholesteatoma comes from the fact that this change resembles a pearl: it is spherical and has a silvery-whitish color.

Perlak is a tumor, although it must be clearly stated here - it is not a cancerous change.

Perlak is composed of normal cells that are simply present in the wrong place - because it is composed of cells of multilayered keratinizing squamous epithelium, cholesterol and keratin deposits.

Perlaki can occur in both children and adults. The incidence of this problem is not high - according to statistics, cholesteatoma is found in 3 to 15 per 100,000 people. Pearly tumors are more common in men.

Perlak: reasons

Due to the fact when patients develop cholesteatoma, there are three types of these changes.

Congenital cholesteatoma . This type of pearly tumor is the rarest and is caused by disturbances in embryogenesis. Despite the fact that in the case of congenital cholesteatoma, the baby comes into the world with its lesion, it is typically not recognized until some time after birth - it usually takes from 4 to 8 years before a diagnosis is made.

Acquired cholesteatomaare divided into primary and secondary cholesteatoma.

Primary cholesteatomaare those when a pearly tumor arises in a person who does not have any ear diseases. In this case, cholesteatoma is most likely caused by abnormal processes of exfoliation of the epidermis in the structures of the hearing organ.

Secondary cholesteatomaappear in patients with some otolaryngological problems. The cause of cholesteatomaAcquired secondary can be primarily various problems that result from damage to the eardrum.

The perforation of the eardrum may occur in the course of otitis media (the formation of cholesteatoma may then result in the development of chronic otitis media) during an operation, but we can also do it … ourselves.

This is why ENT specialists advise against using cotton buds - contrary to appearances, you should not use them to clean your ears (even the producers of these products themselves confirm this - just take a closer look at the information on the packaging).

When analyzing the causes of cholesteatoma, genetic conditions are also taken into account - it turns out that in some families, many of their members develop cholesteatoma, which raises the suspicion that genes contribute to the formation of cholesteatoma.

It is also noticeable that certain problems (including craniofacial defects, e.g. cleft palate) increase the risk of developing cholesteatoma.

Perlak: symptoms

Perlak is a creature that develops slowly, but this change has a tendency to constantly increase its dimensions, thus the ailments that appear in the patient worsen gradually and initially the patient may not even be aware of any disorders.

Hearing disorders are a typical symptom of cholesteatoma - they take the form of hearing loss, which can worsen, and even - in the most extreme cases - may even lead to complete loss of hearing.

Another symptom of cholesteatoma is leakage of contents from the auricle. It usually has a yellowish-greenish color and an unpleasant odor.

The listed compilation - i.e. hearing loss and discharge from the ear - are typical ailments of people with cholesteatoma.

Other problems, such as an earache or a feeling of fullness in the ear, may be less common.

Patients may experience a number of other ailments - they depend, however, on whether and what complications of cholesteatoma occur in the patient.

Perlak: possible complications

Pearly tumors tend to enlarge, which can lead to cholesteatoma damaging adjacent structures.

This may be the case with the facial nerve - the developing cholesteatoma may compress this nerve, leading to the patient developing symptoms of facial nerve paralysis.

Perlak can also damage the labyrinth - in patients who experience such a situation, there may be, among others, dizziness.

  • What symptoms indicate labyrinth disease? Asrecognize labyrinth disorders?

Perlak, unfortunately, can lead to a number of other complications, referred to as intracranial, which include, among others meningitis, brain abscess and thrombophlebitis.

Perlak: recognition

Due to the above-mentioned risks, a patient who may have cholesteatoma - a person struggling with hearing loss and leakage of contents from the ear - should definitely see a doctor.

Otolaryngology specialists deal with the diagnosis and treatment of cholesteatoma.

The basic examination carried out by these doctors and in which cholesteatoma is possible is otoscopy, i.e. an endoscopy of the tympanic membrane.

In fact, it is a basic examination, diagnostics usually need to be supplemented with other tests, e.g. imaging tests (in patients with cholesteatoma, for example, computed tomography may be performed - it allows not only to precisely determine the size of the pearly tumor, but also and thanks to it it is possible to determine whether cholesteatoma is infiltrating any important structures within the skull).

  • Laryngologist (otorhinolaryngologist): what does he do and what diseases does he treat?

Perlak: treatment

Basically, there is only one method of treating cholesteatoma - it is surgery.

Sometimes patients are actually treated with pharmacological treatment before the surgery, although such treatment applies only to those who have severe inflammation.

Once it is mastered - in order to heal cholesteatoma - it is still necessary to perform a procedure during which the entire mass of the tumor will be removed.

Treatment of cholesteatoma does not only involve resection of the tumor. In those people in whom the change has led to hearing loss, treatments are carried out, if possible, to improve their hearing.

Perlak: prognosis

Pearly tumors are completely curable lesions, but the important thing is that - unfortunately - these formations can recur.

The risk of recurrence of cholesteatoma grows the greater the more tumor mass remains in the operated ear.

It is for this reason that ENT specialists who deal with cholesteatoma operations require an extraordinary degree of precision - removing the total mass of the lesion significantly reduces the risk that in the future the patient will struggle with cholesteatoma again.

Sources:

  1. Roland P.S., Cholesteatoma, Medscape; on-line access: https://emedicine.medscape.com/article/860080-overview
  2. Kuczkowski J. et. al., Multiple intra-temporal and intracranial complications of congenital cholesteatoma in a 10-year-old child, Otolaryngologia 2015, 14 (1): 58-64
  3. Rutkowska J. et. al., Cholesteatoma Definition and Classification: A Literature Review, The Journal of International Advanced Otology, 2022
About the authorBow. Tomasz NęckiA graduate of the medical faculty at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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