Young woman with an ear infection, such as cholesteatoma, touching her painful ear.

Cholesteatoma is a non-cancerous growth in the middle ear.

With a name that confuses many, cholesteatoma is a delicate and troublesome problem within the ear. Describing an abnormal skin growth behind the eardrum, the middle ear, cholesteatoma is normally caused by multiple infections. However, there are other causes to note including a dysfunction in the eustachian tube.

What is the Eustachian Tube?

Running to the middle of the ear from the back of the nose, this tube is essential for our hearing. Since it allows air to reach the ear, ear pressure is equalized efficiently and our hearing works as expected. Sadly, an issue can occur with a simple cold along with allergies, sinus infections, and chronic ear infections.

With a failure in the eustachian tube, the middle ear can experience a partial vacuum and, in turn, the eardrum, or certain sections of the eardrum, is pulled out of position. As you can see, each step of the process causes another problem and it ends with a growth or cyst in the middle ear.

When left untreated, willingly or unknowingly, the size of the cholesteatoma can change while causing severe damage to the delicate bones located in the middle ear. If left for too long, hearing loss is experienced and surgery becomes one of just a few select options. Fortunately, there aren’t any serious side effects when the issue is treated which means that permanent hearing loss and muscle paralysis in the face are both unlikely. This being said, there has been cases of all three when the cholesteatoma is allowed to keep growing.

Causes of Cholesteatoma

As we’ve seen, the main causes are problems with the eustachian tube and chronic infections but there are also small numbers of people who are born with a cholesteatoma. Ultimately, this is seen as a birth defect and should be picked up on soon after birth. If children experience numerous ear infections, cholesteatoma can also become a problem at a young age.

Symptoms of Cholesteatoma

With any health issue such as this, the key information comes in knowing the symptoms so it can be recognized early. With cholesteatoma, many are actually drawn to a foul odor before anything else and this is where the ear drains fluids. After this, you might feel building pressure or a sense of fullness in the ear where the sac enlarges over time.

As with ear infections themselves, cholesteatoma will cause discomfort whether it comes through an ache in the ear, a difficulty to fall asleep at night, or a slight loss of hearing. Finally, there may be muscle weakness on the side of the cyst in addition to dizziness. If you experience any of these symptoms, we advise you to visit your doctor as soon as possible. Even if it turns out to be a simple ear infection, this will still need treatment.

Treating Cholesteatoma

As you visit your doctor, they’ll examine the inside of the ear because the signs of a cyst can often be seen early whether it’s a congregation of blood vessels or excess skin cells. If they don’t find anything but are still a little worried, they may ask for you to attend a CT scan which will show the cyst or whatever it may be causing your discomfort.

As with any other cyst, a cholesteatoma is something that needs surgery for removal. Unfortunately, cysts don’t just go away on their own; in fact, they do the opposite and grow. While you’re waiting for surgery, your doctor might suggest ear drops, antibiotics, careful cleaning, and other forms of light therapy.

During surgery, most cases are completed under a general anesthesia with the main aim of removing the cyst. If the cyst is removed, this is great news but it might not be the end of the problem depending on how serious the issue was and the state of your ear now. Typically, a second surgery will be planned at the very least to check the cyst has gone. However, you may also require a reconstruction of the damaged bones in the middle ear; this will improve your hearing and reverse other symptoms experienced. Of course, this will be judged on a case-by-case basis as not all patients would benefit from reconstruction if the damage is too severe.

In terms of the logistics, you’ll be an outpatient and a certain percentage will stay in the facility overnight as a precaution. If the cholesteatoma was extremely damaging, you might be required to stay in hospital for a few days with a course of antibiotics. On the whole, you can expect to need one or two weeks away from work. In the months ahead, check-ups and evaluations will ensure the problem has gone for good.

Summary

Although we can’t provide any prevention tips for congenital cholesteatomas, we do advise visiting the doctor as soon as you notice any of the symptoms we’ve listed. Whether it’s yourself or your child, quick action is the best way to remove the problem and ensure the middle ear bones aren’t damaged. Despite cholesteatoma being a serious ear condition, it is treatable with the right steps.