Cholesteatoma
What is Cholesteatoma?
Cholesteatoma is the skin growth (skin cyst) in the middle ear and mastoid. There are 2 types of cholesteatoma, “acquired” which occurs due to repeated ear infections and “congenital” which is present since birth. When squamous epithelium (skin layer) gets trapped behind the eardrum in the middle ear or mastoid then there is no where for it to escape as it enlarges and leads to cholesteatoma. Cholesteatoma usually grows very slowly, and it causes symptoms as it compresses and erodes surrounding bone and other structures.
Common symptoms of Cholesteatoma:
• Ear discharge due to chronic ear infection
• Hearing loss (“conductive” due to ear drum and ear ossicle damage or “sensorineural” due to inner ear damage)
• Ear blockage, Ear pain, Ear bleeding
• Ringing in ears (tinnitus)
• Vertigo / Dizziness
Cholesteatoma grows very slowly but if left untreated/ unchecked can lead to severe consequences due to important surrounding structures around the middle ear.
• Mastoid abscess due to erosion of mastoid bone and pus collection under the skin
• Total/ profound hearing loss due to damage/ infection of inner ear
• Vertigo due to damage and erosion of balance canal (Semicircular canals)
• Facial asymmetry/ weakness due to involvement of facial nerve
• Meningitis and Brain abscess due to erosion of the skull base bone and spread of infection into brain coverings and brain.
Diagnosis of Cholesteatoma:
• Your doctor will ask for detailed history of your ear symptoms and perform thorough clinical examination including ear microscopy to diagnose cholesteatoma.
• A pure tone audiogram will be performed to check your hearing level and status of hearing loss. Most often patient will have conductive hearing loss due to damage of ear drum and erosion of ear bones(ossicles).
• A CT scan of your ear and mastoid bone (CT Temporal) is done to look for extent of the disease, evaluate anatomy and plan surgical treatment accordingly.