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What is cholesteatoma?
What is cholesteatoma?
Cholesteatoma is an abnormal growth of skin cells in the middle ear that can cause serious ear problems if left untreated. It consists of keratin (skin cells) and can be formed when dead skin cells from the ear canal accumulate in the middle ear. The cholesteatoma can grow and form a cyst, which can damage the surrounding structures, such as the ear bones (ossicles), the middle ear, and even the inner ear.
Causes of cholesteatoma:
Cholesteatoma can occur for several reasons, including:
Eustachian tube dysfunction: If the Eustachian tube (which connects the middle ear to the nose and throat) is not working properly, pressure changes in the ear can cause skin cells to become trapped in the middle ear. This creates an environment where cholesteatoma can develop.
Ear infections: Frequent or prolonged ear infections can lead to the formation of cholesteatoma.
Congenital cholesteatoma: In rare cases, cholesteatoma can be congenital and occur without previous ear infections.
Trauma or surgery: In some cases, cholesteatoma can form as a result of injuries to the ear or previous surgeries.
Symptoms of cholesteatoma:
Cholesteatoma can develop slowly and in many cases can be without symptoms in the early stages. When symptoms do occur, they may include:
Hearing loss: Cholesteatoma can damage the small bones in the middle ear (pinnae), which can lead to hearing loss.
Ear discharge: Fluid or secretions may come from the ear, which may be foul-smelling if there is an infection.
Ear pain: Cholesteatoma can cause pain in the ear, especially if it is associated with an infection.
Pressure sensation in the ear: You may feel a constant sensation of pressure in the ear.
Dizziness: If the cholesteatoma spreads to the inner ear, it can lead to balance problems and dizziness.
How is the diagnosis made?
The diagnosis of cholesteatoma is made by an ear doctor (otorhinolaryngologist) through:
Ear exam: The ear doctor will use an otoscope to look into the ear and assess for signs of cholesteatoma, such as an abnormal growth or discharge from the ear.
Microscopic examination: In some cases, the ear doctor can use a microscope to get a better picture of the condition of the ear canal and middle ear.
CT scan or MRI scan: If there is a need to assess the extent of the cholesteatoma and whether it has affected the surrounding structures, imaging such as a CT or MRI scan may be necessary.
Surgeon (cholesteatoma surgeon)
Mastoidectomy: A common surgical procedure in which the ear doctor removes the cholesteatoma and any infected tissue from the middle ear and the mastoid bone (the part of the skull behind the ear). The surgeon will often also repair damaged earlobes and ensure that there is no further infection.
Reconstruction of the ossicles: If the cholesteatoma has damaged the ossicles, it may be necessary to reconstruct them to restore hearing.
Tympanoplasty: An operation that restores the eardrum and improves hearing if cholesteatoma has affected the eardrum or eardrums.
Postoperative treatment
After surgery, you will need regular follow-ups to ensure that the cholesteatoma does not return and that infections do not occur.
You may be given antibiotics to prevent infections and painkillers to ease post-operative pain.
The ear doctor may recommend that you avoid getting water in the ear for several weeks after the operation, and a special earplug may be necessary when bathing or swimming.
Hearing rehabilitation
If hearing has been affected by cholesteatoma, hearing aids may be necessary until hearing is restored through surgical treatment.
If the cholesteatoma has resulted in permanent hearing loss, hearing aid or cochlear, implant treatment may be recommended depending on the degree of hearing loss.
Complications of cholesteatoma
Without treatment, cholesteatoma can lead to serious complications, including:
Permanent hearing loss: Cholesteatoma can damage the small ossicles of the ear, which can lead to permanent hearing loss.
Infections: Cholesteatoma can cause chronic ear infections, which can spread to the surrounding tissues and lead to mastoiditis or, in rare cases, a brain abscess.
Dizziness and balance problems: If the cholesteatoma affects the inner ear, it can cause dizziness or balance problems.
Destruction of ossicles: Cholesteatoma can damage the small bones of the middle ear, which may require complex reconstruction of these structures.
Long-term follow-up:
After cholesteatoma removal, regular follow-up is often required to ensure that the growth does not return and that any infections are treated in time. Additional surgeries or treatments may be necessary to achieve the best possible hearing and prevent complications.
When should you contact the doctor?
You should contact your ear doctor if you:
- Experience persistent ear pain, even after treatment.
- Have persistent or worsening hearing loss.
- Noticing earwax, especially if it is smelly.
- Experience balance problems or dizziness.
Conclusion:
Cholesteatoma is a serious condition that requires attention and treatment to prevent complications such as hearing loss and infections. The most effective treatment is surgical removal, and with the right treatment you can expect an improvement in both hearing and quality of life.
If you have any questions about your treatment or diagnosis, you are always welcome to contact your doctor or ear specialist.
Contact information
If you have questions or concerns about cholesteatoma and treatment, please contact your ear doctor or otorhinolaryngologist for further information.