Cholesteatoma

What is a Cholesteatoma?

A cholesteatoma  is a collection of skin cells in the middle ear which  gradually increases in size, destroying the bones of the middle ear and causing hearing loss and infection.

What Causes Cholesteatoma?  

When the Eustachian tube is functioning normally, it equalizes ear pressure by moving air from the back of the throat into the middle ear. Allergies and viruses can impair this process, leading to a partial vacuum in the ear.  

This negative pressure stretches the eardrum, creating a pocket or cyst that fills with old skin cells, which can become easily infected. In rare cases, cholesteatoma can be congenital (present at birth).  

What Are the Symptoms of Cholesteatoma?  

Symptoms of cholesteatoma include drainage from the ear, a feeling of fullness, hearing loss, earache and dizziness. Since these symptoms are also present in other conditions, tests such as audiograms (hearing tests) and CT scans can be used to rule out other conditions and confirm the diagnosis. Cholesteatomas continue to grow if not treated and can lead to complications such as: 

• Deafness.
• Facial paralysis. 
• Brain abscess. 
• Meningitis.  

How Is a Cholesteatoma Diagnosed?

A cholesteatoma diagnosis typically begins with a medical history and visual inspection with an otoscope. An audiogram or tympanogram hearing test may be administered to determine the level of hearing loss and a CT scan of the temporal bone may need to be ordered. Some of the symptoms that can lead a physician to suspect a cholesteatoma include:

• History of past middle ear infections or fluid buildup
• Discharge from the ear
• Gradual loss of hearing

How Is Cholesteatoma Treated?  

An otolaryngologist will determine the size and extent of the cholesteatoma and recommend treatment based on these findings. Controlling the infection with antibiotics or eardrops is a crucial first step, but a cholesteatoma almost always requires surgical removal. In addition, follow-up surgery may be necessary to ensure the cholesteatoma is gone and to reconstruct damaged middle ear bones.