Cholesteatoma is a type of abnormal skin growth that is not cancerous.
A cholesteatoma can develop behind the eardrum in the middle ear. In most cases, repeated ear infections are to blame, but there are cases where it is caused by a birth defect.
- A cholesteatoma usually develops as a cyst and sheds old skin. The skin cells build up and cause the growth to become larger.
- Over time, if it gets large enough, this can result in middle ear bone destruction.
There are three primary causes associated with this condition. The first is an eardrum retraction allowing the growth to develop. This retraction may occur when the Eustachian tube is not working normally. With this dysfunction, air is able to get to the space behind the eardrum, essentially suctioning the eardrum into the middle ear over time. The growth in this instance occurs because the outer skin starts to grow into the area located behind the eardrum.
The second cause is a perforated eardrum. When this occurs, skin can grow into the area located behind the eardrum. The third cause is congenital. In this case, at birth, skin existed behind the eardrum.
In most cases, this growth only affects one ear. The following are possible symptoms:
- Ear infection
- Feeling like there is a fullness in the ear
- Difficulty hearing in the affected ear
- Foul-smelling fluid leaking from the ear
- Facial weakness that only affects half of the face
If this condition remains untreated, it is possible for the growth to continue growing and invade other areas of the ear. In the rarest cases, there is a risk of meningitis or an infection in the brain.
Surgery to remove the growth is the typical course of treatment since there is no medication that is able to shrink or eliminate a cholesteatoma. There are two surgical methods doctors might use:
- Tympanoplasty fixes eardrum damage. This is done by filling any holes in the eardrum using muscle or cartilage from elsewhere in the body.
- Mastoidectomy involves removing the growth after surgically opening the mastoid bone. This bone is located behind the ear.
With both surgical options, the patient is administered general anesthesia so that they can sleep through the procedure. Each procedure takes approximately two to three hours to complete. Patients are then sent to recovery and can usually go home shortly after to recover. Patients are discharged with full aftercare instructions that should be followed exactly to reduce the risk of complications.
If a patient has hearing loss prior to the procedure, surgery may help, but there are cases where it does not. These growths can be aggressive. If they are not fully removed, they can recur. Because of this, patients should adhere to all follow-up care.
Since there is the potential for middle ear bones to be negatively impacted, it is important that all cholesteatomas are evaluated by a doctor. This makes it possible to reduce the risk of complications and alleviate any bothersome symptoms.