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What is Cholesteatoma: Cause, Symptoms and Treatment

January 6, 2025

What is Cholesteatoma: Cause, Symptoms and Treatment
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What is a Cholesteatoma?

A cholesteatoma is a benign growth of skin cells located in the middle ear, just behind the eardrum. It can be present at birth or develop due to ongoing ear infections that lead to the eardrum retracting or rupturing. This condition arises when dead skin cells accumulate, often resembling a pearl-like cyst. Common symptoms include a persistent foul-smelling discharge from the ear, hearing loss, and dizziness. In more severe instances, it can affect balance and the function of the facial nerve. 

Symptoms 

The symptoms of cholesteatoma can differ based on whether it is congenital (present at birth) or acquired later in life. Congenital cholesteatomas may not show any symptoms until they grow larger, and are often discovered during routine checkups. However, both types can have the following symptoms: 

  • foul-smelling ear discharge
  • a sensation of pressure in the ear
  • dizziness, and recurrent infections. 

In more severe cases, the cyst may result in hearing loss, tinnitus, or even severe pain in or behind the ear.

As the condition progresses, symptoms can worsen, potentially leading to serious complications like vertigo, facial muscle paralysis, and permanent hearing loss if left untreated. Early warning signs, such as chronic ear discharge or pain, should prompt immediate medical attention to prevent the cyst from causing lasting damage.

Causes 

Cholesteatoma is frequently caused by a retracted eardrum, which happens when there’s an imbalance in air pressure inside and outside the ear, pulling the eardrum inward. This creates a pocket or cyst that can accumulate dead skin cells and other waste materials. The Eustachian tube plays a major role in balancing pressure and can cause cholesteatoma when it does not work properly. Dysfunction of the eustachian tube can arise from chronic ear infections, sinus infections, colds, or allergies, leading to negative pressure and the development of a cholesteatoma, 

Although cholesteatomas can be congenital (present from birth), they are more often linked to chronic ear infections or eardrum perforations. If left untreated, the cyst can enlarge, become infected, and damage nearby structures, including the bones of the middle ear, which can impact hearing, balance, and even facial muscle function. Early intervention is essential to avoid these complications.

Treatment

If left untreated, cholesteatomas typically continue to grow and do not go away on their own. To prevent further damage to the ear and surrounding structures, the main treatment is surgical excision of the cyst. To cure infections and reduce inflammation, ear drops, antibiotics, and expert ear cleaning may be used before surgery. Complete removal of the cyst is the aim of surgery, which is usually done as an outpatient procedure under general anaesthesia. In certain cases, further surgery is required to ensure complete removal or restore damaged ear structures.

Follow-up sessions following surgery are critical for assessing recovery and monitoring for recurrence. If the bones of the ear are injured, a second reconstructive treatment may be required. Although transitory side effects, such as lightheadedness or taste alterations, are possible, they often resolve within a few days. Choleatomas can be successfully treated with surgical techniques such as mastoidectomy and tympanoplasty, which have a high success rate and significantly improve outcomes.

Although it is impossible to avoid congenital cholesteatomas, early detection and treatment are critical. To reduce the risk of developing cholesteatomas, protect your ears from injuries or infections that can injure the eardrum, and seek treatment for persistent or recurring ear infections as soon as possible. Early medical intervention can help to avert complications if a cholesteatoma develops.

Conclusion

Cholesteatoma is a severe but manageable condition that requires an early diagnosis and management to minimise repercussions. Early medical care is essential to maintaining your hearing and overall ear health, regardless of whether the condition is inherited or acquired. See a doctor immediately if you have hearing loss, recurrent ear infections, or other unusual ear issues. The majority of people may successfully manage and recover from this illness with timely treatment.

Frequently Asked Questions

1.Can a cholesteatoma come back after treatment?

Indeed, even after surgery, cholesteatomas can return. To ensure appropriate ear health and monitor for recurrence, routine follow-up sessions are essential.

 2.Is cholesteatoma surgery safe?

Yes, cholesteatoma surgery is typically considered safe and effective. Temporary side effects, such as dizziness or taste changes, are possible but often resolve within a few days.

3.How is a cholesteatoma diagnosed?

A physical ear examination, imaging studies such as CT scans, and hearing tests can all be used to identify cholesteatoma and determine the level of damage.

Disclaimer: We recommend consulting a Doctor before taking any action based on the above shared information.


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