Chronic otitis media and cholesteatoma.

Cholesteatoma may arise because of a number of events, but serous otitis media appears to be the precursor in the majority of instances. Whether one enters into conservative, simple excision of the keratotic mass or a more extensive modified radical mastoidectomy or radical exteriorizing procedure will depend upon whether the cholesteatoma is in a very small "pearl-like" mass, confined to a limited area, or whether it is dispersed to the point where total eradication is all but impossible.