Clinical characteristics of cholesteatoma.

Clinical characteristics of 99 consecutive patients with acquired and perioperatively established aural cholesteatoma were compared with those of 81 patients with chronic otitis without cholesteatoma (controls). The patients answered a questionnaire, and preoperative and perioperative clinical observations were recorded. There were no presenting symptoms or clinical signs that significantly distinguished the cholesteatoma patients. However, these patients had a significantly higher incidence (45%) of previous middle ear surgery than the control patients (30%). The cholesteatomas were not evident until the time of surgical exploration in as many as 38% of cases. Therefore, surgical exploration appears to be the safest way to identify middle ear cholesteatoma.