Cholesteatoma is the type of benign growth of skin located in the the middle ear behind the eardrum. Cholesteatomas often take the form of a cyst (a closed pocket of tissue filled with air, fluid, pus or other material) that sheds layers of old skin that builds up inside the ear.

If untreated, a cholesteatoma can eat into the three small bones located in the middle ear, which can result in nerve deterioration, facial muscle paralysis, deafness, imbalance and vertigo.

Causes of cholesteatoma

Cholesteatoma can be caused by a birth defect (congenital), but it more commonly occurs as a complication of chronic ear infection.

The main cause of cholesteatoma is the buildup of material in the middle ear. Long-term inflammation and malfunction of the eustachian tube leads to chronic negative pressure in the middle ear. This pulls a portion of the eardrum inward, creating a sac or cyst that fills with old skin cells and other debris. The cyst becomes chronically infected and the bones in the ear waste away.

Cholesteatoma Symptoms

• Drainage from the ear that smell unpleasent.
• Hearing loss and recurring discharge from the ear.
• Pressure in one ear.
• Pain or numbness in the ear or around the ear.
• Dizziness

Cholesteatoma Prevention

Fast treatment of chronic ear infection may help prevent some cases of cholesteatoma.

Cholesteatoma Diagnosis & Tests

Inspection of the ear may show a pocket or opening in the eardrum, often with drainage. The deposit of old skin cells may be visible with an otoscope (an instrument used for visual examination of the external ear and eardrum ) .

The following tests may be performed to rule out other causes of dizziness:

1. Electronystagmography (test used clinically to evaluate patients with dizziness, vertigo, or balance dysfunction)
2. Caloric stimulation (is a test which uses differences in temperature to diagnose ear nerve damage as a cause of dizziness)

Your doctor may order a CAT scan (x-ray that that shows the internal part of a person's brain) to further evaluate the exact problem.

Cholesteatoma Treatment

In most cases surgery (mastoidectomy) is performed under general anesthesia. The aim of the surgery is to remove the infected bone and tissue and to achieve an infection-free, dry ear.

In cases of severe ear destruction, reconstruction may not be possible. Reconstruction of the middle ear is not always possible in one operation. A second operation may be performed six to twelve months late in an attempt to restore hearing and, at the same time, inspect the middle ear space and mastoid for residual cholesteatoma.

After surgery, and for quite some time after, it will be necessary to regularly visit your ENT specialist to make sure the ear remains healthy and to remove any build up of wax and debris.

Consequences & Risks of Surgery

Cholesteatoma complications include:

• Temporary taste disturbance can be a consequence of chorda tympani nerve (taste nerve) injury.
• Risks of the surgery include taste disturbance, facial paralysis, recurrence of cholesteatoma, hearing loss and dysequilibrium.