Cholesteatoma

Cholesteatoma is an abnormal growth of skin in the middle ear behind the eardrum. It can be congenital(present from birth), but it more commonly occurs as a complication of chronic ear infections. Individuals with this condition usually experience a painless discharge from the ear.Hearing loss, dizziness, and facial muscle paralysis are rare but can result from continued cholesteatoma growthTreatment usually involves surgery to remove the growth.

Symptoms

 

Early symptoms may include fluid drainage from the ear, sometimes with a foul odor. As the cholesteatoma enlarges, it can lead to:

Occasionally, individuals may experience complications of the central nervous system including:[3]

  • A blood clot in certain veins within the skull, including the sigmoid sinus
  • A collection of infected material between the outer covering of brain and skull (epidural abscess) 
  • Inflammation of the tissue that surrounds the brain and spinal cord (meningitis)

 

Cause

 

A cholesteatoma usually occurs because of poor eustachian tube function in combination with infection in the middle ear. When the eustachian tube is not working correctly, pressure within the middle ear can pull part of the eardrum the wrong way, creating a sac or cyst that fills with old skin cells. If the cyst gets bigger, some of the middle ear bones may break down, affecting hearing. Rarely, a congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones.

 

Treatment

 

Initial treatment may involve careful cleaning of the ear, antibiotics, and eardrops. Therapy aims to stop drainage in the ear by controlling the infectionLarge or more complicated cholesteatomas may require surgery. Cholesteatomas very often continue to grow if they are not removed. Surgery is usually successful.

 

Prognosis

 

Cholesteatomas usually continue to grow if not removed. Surgery is typically successful, but occasional ear cleaning by a healthcare provider may be necessary. Additional surgery may be needed if the cholesteatoma comes back.

In rare cases, complications may arise. These include: