What is Cholesteatoma? Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr Neha A Padia , ENT

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Cholesteatoma is an abnormal, noncancerous growth of skin cells that develops in the middle ear behind the eardrum. It commonly occurs as a result of repeated ear infections or long-term eustachian tube dysfunction. As the growth enlarges, it can damage the bones of the middle ear and affect hearing. Common symptoms include persistent ear discharge, hearing loss, ear pain, and a feeling of fullness in the ear.

If left untreated, cholesteatoma may lead to serious complications such as dizziness, facial nerve damage, or infections that spread to nearby structures. Early diagnosis and appropriate treatment, often involving surgery, can help prevent complications and preserve hearing.

What are the Symptoms of Cholesteatoma?

Recognizing the symptoms of cholesteatoma early can prevent the progression to more serious complications. Symptoms may vary depending on the size and location of the growth.

Hearing Loss

Hearing loss is a common symptom, often resulting from the cholesteatoma interfering with the tiny bones in the middle ear that transmit sound.

Ear Discharge

Persistent, often foul-smelling ear discharge is another telling sign. This occurs as the cholesteatoma can cause chronic ear infections.

Ear Pain and Fullness

Patients may experience a feeling of fullness in the ear, accompanied by pain. This discomfort is due to the pressure exerted by the growing mass within the ear.

Dizziness and Balance Issues

In advanced cases, dizziness and balance problems can occur if the cholesteatoma grows large enough to affect the inner ear structures.

What are the Causes of Cholesteatoma?

Cholesteatoma usually develops due to long-term problems affecting the middle ear and eustachian tube. Repeated ear infections, poor ventilation of the middle ear, or damage to the eardrum can lead to the formation of this abnormal skin growth.

Chronic or recurrent middle ear infections
Eustachian tube dysfunction
Retraction or collapse of the eardrum
Congenital cholesteatoma present at birth
Ear injury or trauma
Previous ear surgery
Persistent perforation of the eardrum
Poor middle ear ventilation

When to see a Doctor for Cholesteatoma?

If you develop symptoms of cholesteatoma, consult an ENT specialist promptly. Early diagnosis and treatment can help prevent hearing loss, chronic ear infections, and serious complications involving the surrounding structures of the ear.

If you have persistent or foul-smelling ear discharge.
If you experience ongoing or worsening hearing loss.
If you develop recurring ear pain or a feeling of fullness in the ear.
If you notice ringing in the ears (tinnitus) or dizziness.
If you have frequent ear infections that do not improve with treatment.
If you develop swelling behind the ear or persistent headaches.
If you experience weakness of the facial muscles or facial numbness.
If your symptoms persist or worsen, consult an ENT specialist promptly for comprehensive evaluation, diagnosis, and appropriate treatment.

Find Ent for Cholesteatoma Treatment Near You

How is Cholesteatoma Diagnosed?

Cholesteatoma is diagnosed through a detailed medical history, physical examination, and specialized tests to evaluate the extent of ear damage. Early diagnosis helps prevent hearing loss and other serious complications.

Otoscopic Examination: An ENT specialist examines the ear canal and eardrum for abnormal skin growth, discharge, or a retraction pocket.
Hearing Tests (Audiometry): Performed to assess the degree of hearing loss caused by the cholesteatoma.
CT Scan of the Temporal Bone: Provides detailed images to determine the size of the cholesteatoma and evaluate bone destruction.
MRI Scan: May be recommended if complications or the spread of the cholesteatoma are suspected.
Ear Discharge Culture: If infection is present, a sample of ear discharge may be tested to identify the causative bacteria and guide antibiotic treatment.

What are the Treatment Options for Cholesteatoma?

Timely treatment is essential to prevent complications such as hearing loss, facial muscle paralysis, and even brain infections. Here are the primary treatment options.

Surgical Intervention

Surgery is the most common treatment for cholesteatoma. The primary goal is to remove the growth and prevent further complications. The specific surgical approach depends on the size and extent of the cholesteatoma.

Mastoidectomy

A mastoidectomy involves removing the cholesteatoma along with some of the mastoid bone surrounding it. This procedure helps in clearing the infection and preventing recurrence.

Tympanoplasty

Tympanoplasty is often performed to repair the eardrum and any other damaged structures in the middle ear. This surgery can restore hearing function in many cases.

Non-Surgical Treatments

While surgery is often necessary, certain non-surgical treatments can help manage symptoms or reduce infection risks.

Antibiotic Therapy

Antibiotic ear drops may be prescribed to treat any underlying infections and reduce inflammation.

Regular Monitoring

For small, asymptomatic cholesteatomas, regular monitoring may be recommended to observe any changes in size or symptoms.

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What is the Recovery Time for Cholesteatoma?

Recovery time can vary based on the severity of the condition and the type of surgery performed. Typically, patients can expect several weeks to a few months for full recovery.

Post-Surgery Care

Post-operative care is crucial for a successful recovery. Patients should follow their surgeon's instructions, which may include keeping the ear dry, avoiding strenuous activities, and attending follow-up appointments.

Hearing Rehabilitation

In some cases, hearing rehabilitation may be necessary. This can include hearing aids or further surgical procedures to improve hearing function.

How does Cholesteatoma Affect Children?

Cholesteatoma can affect individuals of all ages, including children. In pediatric cases, early diagnosis and treatment are vital to prevent developmental delays related to hearing loss.

Causes in Children

In children, cholesteatomas often result from repeated ear infections or Eustachian tube dysfunction, similar to adults. However, congenital cases are more prevalent in younger patients.

Special Considerations

Pediatric cholesteatoma management often requires a multidisciplinary approach involving pediatricians, otolaryngologists, and audiologists to address the unique needs of growing children.