Cholesteatoma

What is a cholesteatoma?

A cholesteatoma is a growth behind your eardrum (tympanic membrane). It develops when dead skin cells gather behind your eardrum to form a lump or cyst that may look like a pearl. You can be born with a cholesteatoma, but it usually happens because you have a retracted eardrum or a ruptured eardrum.

Without treatment, cholesteatomas may become infected or grow large enough to damage your hearing and facial nerve. Surgery to remove the growth is the only way to treat a cholesteatoma.

What are cholesteatoma symptoms?

Symptoms vary depending on whether you’re born with a cholesteatoma (congenital cholesteatoma) or develop one over time (acquired cholesteatoma). Congenital cholesteatomas may not cause symptoms until they get larger. Your child’s pediatrician could find a congenital cholesteatoma in their ear while doing a physical examination. But both congenital and acquired forms of the condition may cause the following symptoms:

• A smelly discharge that may look like pus flowing from your ear or your child’s ear.
• Pressure or a feeling of fullness in your ear.
• Dizziness.
• Recurrent ear infections

Sometimes, the condition can cause hearing loss or tinnitus.

What is the main cause of a cholesteatoma?

One of the main causes is a retracted eardrum. This is when there’s an imbalance between the air inside and outside of your ear. This causes your middle ear to pull in your eardrum. When that happens, you may develop a cyst or pocket that fills up with skin cells and becomes a cholesteatoma.

Chronic ear infections (acute otitis media) or ruptured eardrums can also lead to cholesteatomas. Rarely, children are born with the condition.

How is a cholesteatoma diagnosed?

A healthcare provider will ask about your symptoms and medical history, including whether you have a history of ear infections. They’ll examine your ears with an otoscope, a device that lets them look at your eardrum.

If they suspect you have a cholesteatoma, they’ll refer you to an ear, nose and throat specialist (otolaryngologist). Your otolaryngologist may do the following tests:

• Computed tomography (CT) scan to see if the condition is damaging your ossicles (ear bones).
• Hearing tests including a tympanometry test.

What are treatments for a cholesteatoma?

Treatments depend on the cause and symptoms, but surgeries like mastoidectomy and tympanoplasty are the only ways to remove a cholesteatoma.

Can cholesteatomas be prevented?

You can’t prevent congenital cholesteatomas, but there are things you can do to reduce your risk that you’ll develop one:

• Protect your ears from chronic infections or activities that could rupture your eardrum.
• Talk to a healthcare provider if you have recurring ear infections.

What can I expect if I have a cholesteatoma?

If you’re like most people, surgery to remove a cholesteatoma will take care of your symptoms. But cholesteatomas can come back. Your otolaryngologist may recommend that you have regular checkups. Checkups may include:

• Ear exams and hearing tests to check for signs of new cholesteatoma.
• Ear washing (debridement) to remove skin cells and other tissue build-up.

When should I see my otolaryngologist?

Contact your otolaryngologist if you have symptoms after surgery like:

• Bleeding or discharge from your ear.
• Ear pain.
• Fever of 104 degrees Fahrenheit (38 degrees Celsius).

You should also contact your otolaryngologist if you have symptoms like ear drainage that could mean you’re developing a new cholesteatoma.