Issues with the ears can be stressful, painful and unpleasant. A cholesteatoma is no exception. Here we look at everything you need to know about cholesteatomas.

What is a Cholesteatoma?

A cholesteatoma is a benign skin growth that forms in the middle ear, usually growing behind the eardrum. It is often in the form of a cyst that sheds old skin, which in turn can lead to severe ear and hearing issues.

What Causes a Cholesteatoma?

The Eustachian tube joins the middle ear to the back of the nose in order to regulate air pressure between the outside world and the middle ear. If it is not functioning properly, the pressure in the middle ear reduces and the ear drum can weaken, resulting in a build up of skin cells that can eventually accumulate into a cholesteatoma. The reasons for ineffective functioning of the Eustachian tube include repeated sinus or ear infections, colds or allergies. Repeated middle ear infections are another but less common ause of a cholesteatoma.

Cholesteatoma in children

Although rare, a child can be born with a cholesteatoma. This may not present issues for some years. Factors that put babies at risk of  cholesteatomas include genetic abnormalities, Down’s syndrome, a cleft palate and craniofacial defects.

Cholesteatoma Symptoms

A cholesteatoma can remain symptomless for many years before mild symptoms occur. The main symptoms are:

  • Hearing issues
  • Discharge from the ear
  • An ache or discomfort behind or inside the ear
  • Feeling of pressure in the ear
  • Balance issues and, in severe cases, vertigo
  • In rare cases, facial weakness

If the cholesteatoma becomes infected, symptoms will include inflammation and fever, which require immediate medical attention.

Diagnosis

Your GP or ENT specialist will use an otoscope to check inside your ear for accumulation of skin cells, a abnormally shapred ear drum or evidence of a cyst. Sometimes a CT scan is required. Almost always you will also need a hearing test.

Treatment

A cholesteatoma will not go away by itself, and therefore seeking treatment as soon as symptoms arise is important. The only way to treat a cholesteatoma is with surgery. Antibiotics will often be prescribed initially to reduce the inflammation and keep the area as clean as possible in preparation for surgery.

The surgery involves an inpatient procedure performed under general anaesthetic. The aim is to remove the cholesteatoma entirely in the initial surgery. Follow-up surgery is occasionally  performed to reconstruct the bones of the middle ear in order to improve hearing, or to remove any residual cholesteatoma that has regrown.

London ENT provides a range of specialist ENT treatments and consultations. Contact us on 0203 8657225.