Definition

A cholesteatoma is a type of cyst found in the middle ear behind the eardrum. Cholesteatoma is a noncancerous tumor that forms when the skin of a punctured eardrum grows through the hole in the middle ear. If there is an ear infection, the skin will continue to grow into a cholesteatoma.

While the tumors are benign, the growths can cause damage to the ears by destroying bones in the ear and causing hearing problems. The tumors may also cause nerve damage, hearing loss, deafness, dizziness, and balance problems.

Cholesteatoma is a serious medical problem, and early treatment is crucial for the best outcome. Serious complications may occur if the tumor goes untreated, including destruction of both the middle ear structures causing hearing loss, and inner ear structures causing vertigo (feeling of spinning or whirling). Spreading of infection to the brain can lead to meningitis and brain abscess.

Cholesteatoma responds well to treatments. Patients are likely to recover fully without complications if the tumor is caught and treated early.

Regions of the Ear

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Causes

Cholesteatomas are most often caused by:

  • Ear infections
  • Congenital defects
  • Poorly functioning eustachian tube

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Chronic ear infections increase your chance of developing cholesteatoma.

Symptoms

Symptoms include:

  • Discharge from the ear, sometimes foul-smelling
  • Pressure in the ear
  • Hearing loss
  • Earache
  • Numbness of the ear
  • Dizziness
  • Muscle weakness in the face on the affected side

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam.

Tests may include the following:

  • Hearing tests
  • Balance tests
  • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
  • Electronystagmography—used to test the function of the nerves related to hearing
  • Caloric stimulation—a test which diagnoses nerve damage to the ear
  • X-ray —a test that uses radiation to take a picture of structures inside the body

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Cleaning

Thorough cleaning of the ear is necessary to remove fluid and bacteria. Eardrops are also usually administered.

Surgery

Surgery may be necessary if the tumor is threatening hearing or balance.

Medications

Medications are necessary to dry up the fluid in the ear and include ear drops and oral antibiotics. Antibiotics are prescribed to eliminate any infection in the ear.

Prevention

Cholesteatomas caused by congenital defects cannot be prevented. However, proper treatment of ear infections can prevent cholesteatoma.