title: Cholesteatoma--diagnosing the unsafe ear.
abstract: BACKGROUND
  Cholesteatoma represents the most common destructive disease of the ear, affecting the adult and paediatric population alike.
  
  
  OBJECTIVE
  This article describes the pathogenesis of cholesteatoma and provides a guide to the examination and management of this common disease.
  
  
  CONCLUSIONS
  Despite advances in surgery and imaging, the diagnosis of cholesteatoma is often delayed. A favourable outcome following treatment of a cholesteatoma rests in part on an early diagnosis, and in reducing significant complications and associated morbidity. Primary care physicians should maintain a high index of suspicion for the presence of cholesteatoma, awareness of otoscopic findings and promptly refer for investigations and management.
authors.affiliation: St.Vincents Hospital and Sydney Children's Hospital, Shepherd Centre for Hearing Impaired Children, University of Sydney, New South Wales. pchang@stvincents.com.au
authors.forename: Phillip
authors.initials: P
authors.lastname: Chang
authors.forename: Samuel
authors.initials: S
authors.lastname: Kim
mesh_terms: D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans