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At the turn of the century, medical texts described cholesteatomas as destructive processes that were the primary cause of frequent and usually fatal intracranial complications of common ear disease. These lesions are far less deadly today, in large part due to better antibiotics,imaging techniques, and surgical management, but they remain common. Simply stated, a cholesteatoma is a benign skin tumor, usually occurring in the middle ear and mastoid spaces. Sometimes it can be difficult to diagnose early through the hand-held otoscope. The characteristic glistening white growths can appear as vague, irregular,unremarkable whitish structures that resemble tympanosclerosis, but they can be distinguished more easily under high-power microscopy.

Cholesteatomas were described initially late in the 19th century and misnamed because of their resemblance to cholesterol deposits in the large vessels. In reality, they contain no more cholesterol than the skin cells of which...

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