A cholesteatoma is an abnormal, noncancerous growth that forms behind the eardrum. Cholesteatomas can become large enough to affect hearing and increase your risk of other serious conditions. Early treatment can help you get symptom relief and avoid complications.
A cholesteatoma is an abnormal, noncancerous growth that forms behind the eardrum or from the eardrum. It’s like a cyst that contains skin cells and connective tissue. Without treatment, the mass continues growing. Some cholesteatomas become large. In rare cases, they cause permanent hearing loss and other serious complications.
They affect adults and children. You may face a higher risk if you experience:
There are many types, each with a different cause, including:
Early-stage cholesteatomas might not cause symptoms. Children might not experience symptoms other than hearing loss or recurrent ear infections. In both children and adults, one of the first signs can be discharge.
The discharge may be:
As the cyst grows, it can become infected, causing more drainage and inflammation. You may also experience:
If you have foul-smelling drainage from your ear and it doesn’t go away after two weeks, you should get an evaluation.
The healthcare provider asks about your symptoms and health history. They examine the ear with a handheld device (otoscope). The otoscope helps the provider detect abnormal discharge or a white mass.
If you have signs of an ear cholesteatoma, additional testing may be necessary. You will likely receive a referral to a specialist.
An ear, nose and throat specialist (otolaryngologist) performs an advanced evaluation. This may include:
Cholesteatoma treatment almost always needs surgery but to treat the concurrent infection, it may include:
Almost all patients with cholesteatoma need surgery. You may need more than one procedure:
It’s not possible to prevent some cholesteatomas, especially if they are congenital. Timely ear care is key to avoiding primary or secondary acquired cholesteatoma. This includes getting an evaluation when there are concerns with simple infections or drainage that is not going away.
Cholesteatoma treatments often relieve discomfort and restore most of your hearing. Good results are more likely when a healthcare provider catches the cholesteatoma early. But it can come back, even if cholesteatoma surgery is successful. When a cholesteatoma comes back, hearing loss can worsen and you may need additional treatment.
A cholesteatoma can damage the bones in your middle ear or cause inner ear damage if it’s extensive and spreads. You may experience:
Severe but rare complications may include:
You will need monitoring from an ear, nose and throat specialist for a long time. Care may include:
If the cholesteatoma comes back, you will likely need another surgery. It’s not uncommon for people to need many surgeries throughout their lifetime.
Most people go back to their daily activities. Some people have:
A note from Cleveland Clinic
A cholesteatoma is a cyst-like growth behind the eardrum or involving the ear drum. It’s more common in people with recurring ear infections and eustachian tube issues. Early detection and treatment can help you avoid hearing loss. Ear cholesteatomas that do not respond to medications require surgery. They sometimes come back, which is why lifelong monitoring is necessary.
Last reviewed by a Cleveland Clinic medical professional on 05/14/2021.
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