Causes
This condition typically develops as a result of a malfunction of the Eustachian tube, which connects the middle ear to the back of the throat. When this tube fails to equalize pressure in the middle ear properly, it can create a vacuum that pulls skin cells from the ear canal into the middle ear and mastoid area. Over time, these cells accumulate and form a cyst-like growth, which is the cholesteatoma.
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Cholesteatomas can also be caused by a number of factors, including:
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Ear infection: Cholesteatomas can develop as a complication of ear infections.
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Injury: Cholesteatomas can also develop after an injury to the ear, such as a perforated eardrum.
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Birth defect: Cholesteatomas can be present from birth in some cases.
Symptoms
In its early stages, cholesteatoma might not cause noticeable symptoms but as it grows, it can lead to various problems, including:
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Gradual hearing loss. Learn more about hearing loss here.
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Persistent ear drainage or discharge, which might have an unpleasant odor
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Ear pain or discomfort
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Feeling of fullness or pressure in the ear
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Vertigo or dizziness if the balance system is affected. Learn more about vertigo here.
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If left untreated, cholesteatoma can lead to serious complications, such as an erosion of the surrounding bones, including the ossicles, infections that can spread to the brain or other nearby structures, damage to the facial nerve, formation of an abscess or a cyst, and hearing loss, often progressing to a significant degree.
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Diagnosis
Cholesteatoma can be diagnosed with a physical examination and a hearing test (audiogram, learn more here). In some cases, imaging tests such as CT scans or MRI scans may be needed to get a better view of the cholesteatoma.
Treatment
Treatment for cholesteatoma typically involves surgery to remove the growth. The type of surgery will depend on the size and location of the cholesteatoma. In some cases, surgery may be performed to repair the eardrum and improve hearing.​
Mastoidectomy
Mastoidectomy is a common surgical procedure used to eliminate the cholesteatoma and prevent its recurrence. During the surgery, the surgeon creates an incision behind the ear and removes the infected and abnormal tissue from the middle ear and mastoid bone.
Tympanoplasty
Tympanoplasty involves using graft material to repair the perforated eardrum and close any communication between the middle ear and the external ear canal. This procedure helps to prevent recurrent infections and improves hearing capabilities.
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Learn more about tympanoplasty here.
If you suspect you might have cholesteatoma or if you are experiencing symptoms such as persistent ear drainage, hearing loss, or ear pain, it's essential to consult with an ear, nose, and throat (ENT) specialist. An accurate diagnosis and timely treatment can help prevent further complications and preserve your hearing and ear health.