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.
Most of the time, patients do not know a cholesteatoma is present. The expanding sac generally causes destruction of the ear drum and ossicles (bones of hearing). This causes hearing loss. There can be discharge from the ear. It is usually intermittent (comes and goes), but can be persistent.