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.
As the cholesteatoma pouch or sac enlarges, it can cause a full feeling or pressure in the ear, along with hearing loss. (An ache behind or in the ear, especially at night, may cause significant discomfort.) Dizziness, or muscle weakness on one side of the face (the side of the infected ear) can also occur.