What is cholesteatoma?
What is cholesteatoma?
Cholesteatoma is an abnormal growth of skin cells in the middle ear that can lead to significant complications if left untreated. It consists of keratin (skin cells) and typically forms when dead skin cells from the ear canal accumulate in the middle ear. As the cholesteatoma grows, it can form a cyst that may damage surrounding structures, including the ossicles (the small bones in the ear), the middle ear, and even the inner ear. If not treated, cholesteatoma can lead to hearing loss, infections, and other serious ear problems.
Causes of cholesteatoma:
Cholesteatoma can occur for several reasons, including:
Cholesteatoma can develop due to several causes, including:
Eustachian Tube Dysfunction: If the Eustachian tube, which connects the middle ear to the nose and throat, is not functioning properly, it can cause pressure changes in the ear. This can lead to the trapping of skin cells in the middle ear, creating an environment where cholesteatoma may form.
Ear Infections: Frequent or chronic ear infections can result in the development of cholesteatoma. Ongoing inflammation and fluid buildup can encourage the growth of skin cells in the middle ear.
Congenital Cholesteatoma: In rare cases, cholesteatoma may be congenital, meaning it develops in the ear even without prior ear infections or other underlying conditions.
Trauma or Surgery: Cholesteatoma can sometimes form as a result of ear injuries or previous surgeries, leading to scarring and changes in the middle ear that allow the abnormal growth of skin cells.
If left untreated, cholesteatoma can cause serious complications, including hearing loss, infections, and damage to the structures of the ear. It is important to consult with a specialist for proper diagnosis and treatment.
Symptoms of cholesteatoma:
Cholesteatoma can develop slowly and in many cases may be asymptomatic in the early stages. When symptoms do occur, they may include:
Hearing loss: Cholesteatoma can damage the small bones in the middle ear (the ossicles), which can lead to hearing loss.
Earwax: Fluid or secretion 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 pressure sensation 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 examination: 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 otolaryngologist may 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 CT or MRI scan may be necessary.
Surgeon (cholesteatoma surgeon)
Mastoidektomi: This is a common surgical procedure where the ear specialist 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 may also repair any damaged ossicles (ear bones) and ensure 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: This is a surgery that repairs the eardrum and improves hearing if the cholesteatoma has affected the eardrum or ossicles.
These procedures aim to remove the cholesteatoma, repair any damage caused, and improve or restore hearing function. It is essential to address cholesteatoma as early as possible to prevent further complications.
Postoperative care
After the operation, you will need regular follow-ups to ensure that the cholesteatoma does not return and that no infections develop.
You may be prescribed antibiotics to prevent infections and painkillers to alleviate postoperative pain.
The ear specialist may recommend avoiding getting water in the ear for several weeks after the surgery. It may also be necessary to use a special earplug while bathing or swimming.
Hearing rehabilitation
If the hearing has been affected by the cholesteatoma, hearing aids may be necessary until the hearing is restored through surgical treatment.
If the cholesteatoma has caused permanent hearing loss, a hearing aid or cochlear implant treatment may be recommended, depending on the degree of hearing impairment.
Complications of cholesteatoma
Without treatment, cholesteatoma can lead to serious complications, including:
Permanent hearing loss: Cholesteatoma can damage the small ear bones, 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 problems with balance.
Destruction of ear bones: 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 promptly. 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:
- Experiencing persistent ear pain, even after treatment.
- Have persistent or worsening hearing loss.
- Notices ear discharge, especially if it is smelly.
- Experiencing 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 any questions or concerns about cholesteatoma and treatment, please feel free to contact your ear doctor or otorhinolaryngologist for further information.