<prompt> Cholesteatoma is commonly aw: PGI June 2008Attico-antralTubotympanicTympanosclersisForeign body in ear  <response>: Ans, A. Attico-antral Keratosis obturans is collection of a pearly white mass of desqumated epithelial cells in the deep meatus- Dhingra 5th61Cholesteatoma is commonly aw atticontral or unsafe of CSOMQDifferences bw Atticoantral and Tubotympanic type of CSOM Dhingra 5th77FeatureTubotympanic or Safe typeQAtticoantral or Unsafe typeQDischargeProfuse, mucoid QScanty, purulent, foul- smellingQPerforationCentralQAttic or marginalQGranulationsUncommon QCommonQPolypPaleRed and fleshyCholesteatomaAbsentPresentComplicationsRareQCommonQAudiogramMild to moderate conductive deafnessConductive or mixed deafness Cholesteatoma Cholesteatoma, stratified squamous epithelium in the middle ear or mastoid, occurs frequently in adults. This is a benign, slowly growing lesion that destroys bone and normal ear tissue. Theories of pathogenesis include traumatic implantation and invasion, immigration and invasion through a perforation, and metaplasia following chronic infection and irritation.On examination, there is often a perforation of the tympanic membrane filled with cheesy white squamous debris. A chronically draining ear that fails to respond to appropriate antibiotic therapy should raise suspicion of a cholesteatoma.Conductive hearing loss secondary to ossicular erosion is common. Surgery is required to remove this destructive process. 