Family Nurse Practitioner Exam

In an otoscopic exam of an 8-year-old with chronic otitis media, a cauliflower-like growth is observed. What is this condition?

1. Chronic perforation of the tympanic membrane

2. Chronic mastoiditis

3. Cholesteatoma

4. Cancer of the middle ear

The correct answer is: Cholesteatoma

The observed cauliflower-like growth during the otoscopic examination indicates the presence of a cholesteatoma, a destructive and expanding growth of skin cells in the middle ear. Cholesteatomas often occur due to chronic otitis media, wherein the repeated infections lead to the accumulation of skin cells and other debris, resulting in a cyst-like formation. This growth can cause erosion of surrounding structures, leading to complications such as hearing loss, and it may also become infected. Cholesteatomas are characterized by their unique appearance and the destructive nature of their growth, which differentiates them from other potential conditions. While chronic perforation of the tympanic membrane, chronic mastoiditis, and cancer of the middle ear might present with similar symptoms such as hearing loss or persistent ear drainage, they do not typically produce the distinctive cauliflower-like pattern seen in cholesteatomas. Recognizing cholesteatomas early is crucial for treatment, as they can lead to serious complications if left untreated.