Colesteatoma: Etiopatogenia, hallazgos clínicos, métodos diagnósticos y manejo

Dra. María Catalina Martén Sáenz
Médico general, graduada de la Universidad de Ciencias Médicas (UCIMED)
Investigadora independiente, San José, Costa Rica.

Dr. Sebastian Waugh Chacón
Médico general, graduado de la Universidad de Costa Rica (UCR)
Investigador independiente, San José, Costa Rica.

Dra. Sofía Valverde Solano
Médico general, graduada de la Universidad de Ciencias Médicas (UCIMED)
Investigadora independiente, San José, Costa Rica.

Resumen

El colesteatoma es una enfermedad benigna de caracterizada por un crecimiento de epitelio estratificado queratinizante en forma de quiste con capacidad invasiva localizado en el oido medio. La fisiopatología aún no está completamente descubierta sin embargo la teoría más fundamentada explica que se originan tras la disfunción en la trompa de Eustaquio que ocasiona un fenómeno de vacío en el oido medio con retracción de la membrana timpánica provocando que el epitelio escamoso que la recubre se acumule en forma de quiste expansivo.

Esta es una enfermedad de crecimiento progresivo por lo que puede cursar asintomática y progresar a síntomas como hipoacusia conductiva u otorrea hasta síntomas de invasión local como tinitus, vértigo, parálisis facial o abscesos cerebrales. A la otoscopía se visualiza como una masa billante, blanquecina y compresible. Su manejo es meramente quirúrgico con el propósito de disecar por completo la lesión y mejorar la audición del paciente.

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Palabras claves

Colesteatoma, clasificación, colesteatoma congénito, colesteatoma adquirido, mastoidectomía abierta, mastoidectomía cerrada.

Abstract

Cholesteatoma is a benign disease characterized by a growth of keratinizing stratified epithelium in the form of a cyst with invasive capacity located in the middle ear. The pathophysiology is not yet fully discovered, however the most fundamental theory explains that they originate after Eustachian tube dysfunction that causes a vacuum phenomenon in the middle ear with retraction of the tympanic membrane, causing the squamous epithelium that covers it to shrink. accumulate in the form of an expanding cyst. This is a disease of progressive growth, so it can be asymptomatic and progress to symptoms such as conductive hearing loss or otorrhea to symptoms of local invasion such as tinnitus, vertigo, facial paralysis or brain abscesses. On otoscopy it is visualized as a shiny, whitish and compressible mass. Its management is purely surgical with the purpose of completely dissecting the lesion and improving the patient's hearing.

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Keywords

Cholesteatoma, classification, congenital cholesteatoma, acquired cholesteatoma, open mastoidectomy, closed mastoidectomy.

Bibliografía

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