4 The Definition of Professional Boundaries â¢ Mutually understood, unspoken physical and emotional limits of the relationship between the client and the counselor. â¢ When altered, what is allowed in the relationship becomes ambiguous.
Cholesteatoma usually affects only one ear (it is unilateral). The most common initial symptoms are a smelly discharge from the ear, and some hearing loss. You are also likely to have had previous problems with ear infections. Other symptoms that may occur include a ringing sound in the ear (tinnitus) and headache.
Center for Hearing and Balance. Cholesteatoma. Cholesteatoma is a skin-lined cyst that begins at the margin of the eardrum and invades the middle ear and mastoid (arrow). This photograph shows a typical cholesteatoma that has eaten into the bone, wrapped around the incus (hearing bone), and collected layers of dead skin.