A cholesteatoma is an abnormal growth of skin cells behind the eardrum. It can cause hearing loss, ear infections, dizziness, and facial nerve damage. It is not cancer, but it can be serious if left untreated.
Cholesteatomas are classified as congenital or acquired. Congenital cholesteatoma is present at birth and is very rare. Acquired cholesteatoma is more common and can occur in both children and adults.
Repeated ear infections that damage the eardrum or the eustachian tube, which connects the middle ear to the back of the nose and throat
Poor function of the eustachian tube, which leads to negative pressure and fluid buildup in the middle ear
Injury or trauma to the eardrum, such as from a foreign object, ear cleaning, or ear surgery
Genetic factors that make some people more prone to developing cholesteatoma
The symptoms of cholesteatoma may vary depending on the size and location of the growth. They may include:
Ear discharge that is foul-smelling, yellow, or bloody
Hearing loss in the affected ear
Ear pain or pressure
Tinnitus, or ringing in the ear
Dizziness or vertigo
Headache
Facial weakness or paralysis on the side of the affected ear
To diagnose cholesteatoma, a doctor will examine the ear with a special instrument called an otoscope or a microscope. They may also perform tests such as:
Audiometry, which measures the hearing level and the type of hearing loss
Tympanometry, which tests the function of the eardrum and the middle ear
CT scan or MRI, which provide detailed images of the ear and the surrounding structures
An effective treatment for cholesteatoma is surgery. In surgery, the growth and any damaged tissue or bone are removed, and the ear is restored to function. Depending on the extent and location of the cholesteatoma, different types of surgery are used. A few of them are:
Mastoidectomy, which removes the cholesteatoma and the infected part of the mastoid bone, which is the bone behind the ear
Tympanoplasty, which repairs the eardrum and the middle ear bones
Ossiculoplasty, which replaces the damaged middle ear bones with artificial ones
Canal wall down or canal wall up, which are different techniques to create a cavity in the ear to prevent recurrence of the cholesteatoma
Depending on the individual case and the type of surgery, surgery may be done under general anesthesia or local anesthesia, and may require one or more procedures. Some possible complications of surgery include:
Infection
Bleeding
Recurrence of the cholesteatoma
Hearing loss
Facial nerve injury
Balance problems
To prevent cholesteatoma, it is important to:
Treat ear infections promptly and follow the doctor's instructions
Keep the ears dry and avoid swimming or diving with ear infections
Avoid inserting objects or cotton swabs in the ear
Have regular ear check-ups, especially if there is a history of ear problems or surgery
Seek medical attention if there are any signs or symptoms of cholesteatoma
