Cholesteatoma
A cholesteatoma is an abnormal skin growth behind the eardrum, normally the result of severe or repeated cases of 'glue ear' (otitis media) or other middle ear infections.
The growth can increase in size, forming a skin cyst or pouch and damaging the delicate bones of the middle ear, affecting hearing and balance.
Cholesteatomas are slow growing, non-malignant growths but, left untreated, they can result in serious damage to the middle and inner ear. The enzymes which are contained in cholesteatomas are activated through contact with water. If the ear is infected, these enzymes will react with the fluid to erode the bone to the inner ear, potentially causing hearing loss and, if facial nerves are also affected, paralysis. In rare and extreme cases, untreated cholesteatomas can erode the intercranial cavity, causing more serious infections such as meningitis.
Although middle ear infections such as glue ear are the principal cause of cholesteatomas, the condition is relatively rare and the vast majority of middle ear infections will leave no lasting damage.
What are the symptoms?
Cholesteatomas are not easy to detect without an ear examination. For this reason, doctors advise regular ear examinations for patients with a history of recurring ear infections. However, noticeable symptoms can include:
- hearing loss
- recurring discharge from the ear
- dizziness (in advanced cases)
- a feeling of 'fullness' or pressure in the ear
- facial muscle weakness (in advanced cases)
- an ache behind or in the ear (especially at night)
What treatment is available?
The first stage of treatment of cholesteatoma will involve tackling the underlying infection which is causing the growth. A course of antibiotics combined with a thorough cleaning of the ear will often be sufficient. Cholesteatomas are often associated with the growth of small polyps. Again, before treatment can progress, these polyps must first be removed either with antibiotics or surgical intervention.
Your ENT specialist will also determine the size of the cholesteatoma with a CAT scan. This will indicate the level of damage which the cholesteatoma has caused.
Once the infection has been successfully treated and the CAT scan has been taken, a decision on whether or not to proceed with surgery will be made.
