Cholesteatoma
Updated August 19, 2014.
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
What is a Cholesteatoma?
A cholesteatoma is a non-cancerous growth inside of the middle ear. They mostly consist of skin cells called squamous cell epithelium, these cells can shed and then build up inside of the ear. Sometimes they even become infected. There are three types of cholesteatomas:
Who is at Risk for Developing Cholesteatoma?
Individuals with conditions that affect auditory tube function are at a higher risk of getting a cholesteatoma. These conditions may include:
Symptoms of Cholesteatoma
The symptoms of cholesteatoma vary greatly based on individual circumstances and the size of the growth but may include:
If left untreated cholesteatoma can lead to other symptoms and complications including:
Diagnosing Cholesteatoma
A doctor may suspect cholesteatoma if your symptoms are consistent with the disorder and you have a history of auditory tube dysfunction. Cholesteatoma may also be suspected if your doctor has visualized drainage and granulation tissue in your ear canal and the middle ear, you have tried antibiotics, and the antibiotics have been unsuccessful in resolving your symptoms. When using an otoscope to visualize your eardrum your doctor will most likely see that the eardrum has ruptured or is not intact (eardrum perforation is present in 90% of cases). Medical imaging, specifically CT scans, can also be useful in diagnosing cholesteatoma.
Treatment for Cholesteatoma
Cholesteatomas should be surgically removed almost without exception. There are many different surgical techniques used depending on individual circumstances and the preference of your surgeon. Most techniques involve removing the growth, and insomuch as possible repairing any damage it may have caused to surrounding structures. For example, repairing a perforated ear drum.
As with any type of surgical procedure there are always risks. You should discuss these risks with your surgeon and your anesthesiologist beforehand.
Prognosis
As previously mentioned, failing to treat a cholesteatoma can lead to serious complications, even death. Fortunately, early diagnosis and timely treatments have made these kind of complications rare and while it can be serious, cholesteatoma is considered a very treatable condition. Almost all cholesteatomas can be surgically removed. However, occasionally multiple surgeries are required to completely remove the growth and repair any damage it may have caused. It is also possible for a cholesteatoma to regrow after it has been removed. While serious complications of cholesteatoma are mostly rare the condition remains a significant cause of permanent hearing loss.
Sources:
American Academy of Otolaryngology - Head and Neck Surgery. Cholesteatoma. Accessed: July 28, 2014 from http://www.entnet.org/content/cholesteatoma
Medscape. Cholesteatoma. Accessed: July 28, 2014 from http://emedicine.medscape.com/article/860080-overview#aw2aab6b2b5
Medline Plus. Cholesteatoma. Accessed: July 28, 2014 from http://www.nlm.nih.gov/medlineplus/ency/article/001050.htm
Written or reviewed by a board-certified physician. See About.com's Medical Review Board.
What is a Cholesteatoma?
A cholesteatoma is a non-cancerous growth inside of the middle ear. They mostly consist of skin cells called squamous cell epithelium, these cells can shed and then build up inside of the ear. Sometimes they even become infected. There are three types of cholesteatomas:
- Congenital - Congenital cholesteatomas develop during the womb before a baby is born. They are rare and differ from other cholesteatomas because the ear drum usually appears normal.
- Primary Acquired Cholesteatoma - This type of cholesteatoma usually occurs when auditory tube dysfunction causes negative pressure inside of the ear and the ear drum becomes retracted. This creates a cyst or pouch which eventually develops into a cholesteatoma. This is the most common type.
- Secondary Acquired Cholesteatoma - This type of cholesteatoma usually occurs as the result of trauma to the ear drum (ruptured or perforated ear drums) from barotrauma or even ear surgery such as the insertion of ventilation tubes.
Who is at Risk for Developing Cholesteatoma?
Individuals with conditions that affect auditory tube function are at a higher risk of getting a cholesteatoma. These conditions may include:
- chronic middle ear infections
- chronic fluid in the ears
- chronic sinusitis
Symptoms of Cholesteatoma
The symptoms of cholesteatoma vary greatly based on individual circumstances and the size of the growth but may include:
- ear pain
- hearing loss
- ear drainage
- pressure in the ears
- dizziness or vertigo (uncommon)
If left untreated cholesteatoma can lead to other symptoms and complications including:
- neurological symptoms
- facial paralysis
- neck abcess
- labrynthitis
- meningitis
- permanent hearing loss
- infection may spread to surrounding bones or even the brain in rare cases
Diagnosing Cholesteatoma
A doctor may suspect cholesteatoma if your symptoms are consistent with the disorder and you have a history of auditory tube dysfunction. Cholesteatoma may also be suspected if your doctor has visualized drainage and granulation tissue in your ear canal and the middle ear, you have tried antibiotics, and the antibiotics have been unsuccessful in resolving your symptoms. When using an otoscope to visualize your eardrum your doctor will most likely see that the eardrum has ruptured or is not intact (eardrum perforation is present in 90% of cases). Medical imaging, specifically CT scans, can also be useful in diagnosing cholesteatoma.
Treatment for Cholesteatoma
Cholesteatomas should be surgically removed almost without exception. There are many different surgical techniques used depending on individual circumstances and the preference of your surgeon. Most techniques involve removing the growth, and insomuch as possible repairing any damage it may have caused to surrounding structures. For example, repairing a perforated ear drum.
As with any type of surgical procedure there are always risks. You should discuss these risks with your surgeon and your anesthesiologist beforehand.
Prognosis
As previously mentioned, failing to treat a cholesteatoma can lead to serious complications, even death. Fortunately, early diagnosis and timely treatments have made these kind of complications rare and while it can be serious, cholesteatoma is considered a very treatable condition. Almost all cholesteatomas can be surgically removed. However, occasionally multiple surgeries are required to completely remove the growth and repair any damage it may have caused. It is also possible for a cholesteatoma to regrow after it has been removed. While serious complications of cholesteatoma are mostly rare the condition remains a significant cause of permanent hearing loss.
Sources:
American Academy of Otolaryngology - Head and Neck Surgery. Cholesteatoma. Accessed: July 28, 2014 from http://www.entnet.org/content/cholesteatoma
Medscape. Cholesteatoma. Accessed: July 28, 2014 from http://emedicine.medscape.com/article/860080-overview#aw2aab6b2b5
Medline Plus. Cholesteatoma. Accessed: July 28, 2014 from http://www.nlm.nih.gov/medlineplus/ency/article/001050.htm