What is Cholesteatoma?
Cholesteatoma is an abnormal skin growth that occurs in the middle ear, behind the eardrum. Although not cancerous, it behaves destructively by expanding and eroding nearby delicate bones and tissues inside the ear. This growth can lead to chronic infections, hearing loss, balance issues, and, in rare cases, serious complications if untreated.
The growth occurs when skin cells trapped in the middle ear multiply and accumulate, often due to repeated ear infections or dysfunction of the Eustachian tube. It is essential to address cholesteatoma early, as the damage can become irreversible.
Symptoms of Cholesteatoma
Cholesteatoma symptoms can develop gradually and sometimes go unnoticed in the early stages. Common signs include:
- Persistent or recurring ear infections
- Discharge from the ear — often foul-smelling and continuous
- Hearing loss — usually gradual and affects one ear
- Ear fullness or pressure
- Ear pain or discomfort
- Tinnitus — ringing or buzzing sounds in the ear
- Dizziness or balance difficulties in more advanced cases
- Facial muscle weakness (rare but serious)
If you notice any of these symptoms, especially ongoing discharge or changes in hearing, it’s essential to seek prompt assessment at one of our Studios.
Causes and Risk Factors
Cholesteatoma often develops as a complication of:
- Chronic middle ear infections (otitis media): Repeated infections can alter ear anatomy.
- Repeated Eustachian tube dysfunction: Which prevents normal ear ventilation and can create a retraction pocket where skin cells gather.
- Ear trauma or perforated eardrum: Providing an entry point for skin cells.
- Congenital factors: Some people are born with a small cholesteatoma (congenital cholesteatoma).
Individuals who experience frequent ear infections or have undergone previous ear surgery may be at a higher risk. It can affect people of all ages, but is more common in children and young adult
Treatment Options and Coping Strategies
Cholesteatoma does not resolve on its own and usually requires surgical removal. Treatment approaches include:
- Surgery: To remove the cholesteatoma and repair damaged ear structures. This may involve one or more operations.
- Antibiotics: To treat or prevent infections before and after surgery.
- Hearing rehabilitation: Through the use of hearing aids, individuals with residual hearing loss after surgery can benefit.
Following surgery, regular follow-up care with your ENT specialist is crucial to monitor for recurrence and ensure proper healing. Coping strategies during treatment include:
- Keeping the ear dry and avoiding water exposure as advised by your specialist.
- Managing infections promptly with prescribed medications.
- Using ear protection in noisy environments to preserve remaining hearing.
- Seeking support from audiologists for hearing assessment and rehabilitation after surgery.
For New Zealanders, public health services and support networks can provide guidance throughout treatment. For more information about ear health and ENT services, please visit the Ministry of Health website here.
Frequently Asked Questions (FAQs) About Cholesteatoma
Find answers to some of the most frequently asked questions about Cholesteatoma
A cholesteatoma is an abnormal, non-cancerous skin growth that develops in the middle ear, behind the eardrum. It gradually expands over time, eroding delicate bones and tissues within the ear, which can potentially lead to chronic infections and hearing loss.
It commonly develops from repeated middle ear infections or Eustachian tube dysfunction, which can create a retraction pocket in the eardrum. This pocket traps dead skin cells, which then accumulate and grow, forming a cholesteatoma.
Look out for persistent ear discharge (often foul-smelling), progressive hearing loss in one ear, ear pain, or a feeling of fullness. A doctor, typically an ENT specialist, will perform a microscopic examination and possibly imaging scans (like a CT scan) to diagnose it.
Yes, as the growth expands, it can damage the small bones (ossicles) in the middle ear, which are responsible for transmitting sound, leading to gradual conductive hearing loss, typically in one ear.
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Hi, I’m Chris! I'm an audiologist at Resonate Health Whanganui, and my number one priority is making sure every person I see feels comfortable and fully in control of their hearing healthcare journey.