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.
WHAT IS A CHOLESTEATOMA? Cholesteatoma is a growth of skin cells occurring behind the ear drum that causes damage to the ear drum itself, the middle ear bones and in some instances the inner ear, the facial nerve, the barrier between the brain and the ear, and even the blood vessels supplying brain structures.