This topic provides information about Cholesteatoma.
What is a cholesteatoma?
A cholesteatoma is an abnormal skin growth in the middle ear, behind the eardrum. Cholesteatomas form as cysts or sacs that shed skin into the middle ear space. The cholesteatoma can continue to grow in size and can destroy the three small bones of the inner ear (ossicles).
What causes a cholesteatoma?
The most common cause of a cholesteatoma is longstanding eustachian tube dysfunction or several infections of the middle ear.
When the eustachian tube is not functioning properly, the pressure behind the eardrum will cause the eardrum to be retracted, or pull back. This can cause a pocket behind the eardrum. As dead skin continues to shed from this sac a cholesteatoma can form. This may also happen in a smiliar way with a perforation, or hole, in the eardrum.
A rare congenital cholesteatoma can be present at birth.
You have a greater chance of getting a cholesteatoma if you have chronic otitis media or eustachian tube dysfunction.
What are the symptoms?
Symptoms of a cholesteatoma can include:
- Hearing loss in the affected ear
- Tinnitus in the affected ear
- Discharge from the ear with or without an odor
- Pressure or fullness in the ear
In severe cases, permanent hearing loss and/or facial paralysis can occur.
How is a cholesteatoma diagnosed?
A cholesteatoma is diagnosed by an otolaryngologist after medical evaluation of the ear. Often times a comprehensive hearing evaluation will be performed by an audiologist to help confirm diagnosis and determine the extent of the hearing loss. A CT scan can also be used for diagnosis.
A cholesteatoma will often cause a conductive hearing loss in the affected ear. The severity of the hearing loss will be determined by how large the cholesteatoma has grown and whether it has caused any destruction of the ossicles (middle ear bones).
How is it treated?
Initial treatment of a cholesteatoma may include ear cleanings and antibiotics. It is important to keep the ear dry, especially if there is a perforation of the eardrum. In this case, earplugs are recommended to be worn if the ear is to get wet.
Surgery may be required with a larger cholesteatoma. The goal of surgery is to remove the cholesteatoma, prevent infection, and restore hearing.
Does a cholesteatoma cause lasting problems?
If the cholesteatoma is not removed it can continue to grow, causing destruction of the middle ear bones and permanent hearing loss. If left untreated, infection of the cholesteatoma can spread to the surrounding structures of the inner ear and brain. This can cause more serious conditions such as deafness, meningitis, brain abcess, and even death. A cholesteatoma should never be left untreated.