Cholesteatoma is an abnormal skin growth that develops inside the ear, behind the eardrum. It can cause symptoms such as foul-smelling ear drainage, ringing in the ear, and hearing loss.
Most cases develop after repeated ear infections or problems with the Eustachian tubes. Rarely, it may be present from birth.
Cholesteatoma treatment is managed by an ENT specialist. It includes regular medical follow-up and, in most cases, surgery to remove the skin growth and help preserve hearing.
Main symptoms
The most common symptoms associated with cholesteatoma include:
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Foul-smelling ear drainage
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Hearing loss
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A feeling of pressure or fullness in the ear
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Dizziness or imbalance
In advanced cases, cholesteatoma can cause facial paralysis, making it difficult to move the affected side of the face.
Is cholesteatoma cancer?
Cholesteatoma is not cancer. It is a benign skin growth in the ear that can damage nearby bones and tissues, but it does not spread to other parts of the body like a malignant tumor.
Confirming a diagnosis
Cholesteatoma is mainly diagnosed by an ENT specialist. Diagnosis is usually made by examining the eardrum with an otoscope, and hearing tests may be performed to assess hearing loss.
The doctor may order imaging tests, such as a CT scan, to check the condition of the ear bones. A brain MRI may also be requested to help distinguish cholesteatoma from other ear conditions or evaluate recurrence.
Possible causes
The possible causes of cholesteatoma can be classified as:
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Acquired cholesteatoma: This is the most common type and usually develops after repeated or improperly treated ear infections or problems with the Eustachian tube, such as dysfunction that pulls the eardrum inward.
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Congenital cholesteatoma: This is rare and is present from birth. It happens when skin cells become trapped behind an intact eardrum during fetal development.
Cholesteatoma can also develop after a traumatic eardrum perforation, which allows skin from the ear canal to grow into the middle ear.
Also recommended: Perforated Eardrum: Symptoms, Causes & Treatment tuasaude.com/en/perforated-eardrumTreatment options
Treatment for cholesteatoma may include:
1. Surgery
Surgery is the main treatment for cholesteatoma. The goal is to control the disease and preserve hearing.
During the procedure, the doctor removes the skin growth from the middle ear and mastoid bone to prevent damage to nearby structures. According to ENT Health, from the American Academy of Otolaryngology, cholesteatoma surgery also aims to clear the infection and prevent further complications.
Depending on the case, different techniques may be used, such as opening part of the ear, called a mastoidectomy, or reconstructing the eardrum, called a tympanoplasty.
2. Medications
Medications do not cure cholesteatoma, but they may be used to control infection and inflammation before or after surgery.
Antibiotics, such as amoxicillin or ciprofloxacin, may help reduce discharge and infection. Ear drops, such as ofloxacin or ciprofloxacin with dexamethasone, are commonly used to help control infection, reduce inflammation, and prevent complications.
3. Follow-up
Even after treatment, cholesteatoma can come back. Therefore, regular follow-up with an ENT specialist is important and may include ear exams and, in some cases, imaging tests to make sure the disease has not returned.
Is cholesteatoma curable?
After surgery, cholesteatoma can be controlled, but it is not considered fully “cured,” because there is a risk that it can come back.
For this reason, regular follow-up is necessary even after the procedure to reduce the risk of recurrence.
Potential complications
If left untreated, cholesteatoma can cause complications, including:
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Hearing loss due to destruction of the small bones in the middle ear
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Facial paralysis if the facial nerves are affected
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Serious infections that can spread to nearby structures
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Dizziness and imbalance if the inner ear is affected
In more severe and advanced cases, cholesteatoma can spread to tissues near the ear and brain, causing serious infections such as meningitis, which is inflammation of the membranes that surround the brain and spinal cord.