A cholesteatoma is a noncancerous skin growth in the middle ear, behind the eardrum.
The Eustachian tube, which connects the middle ear to the back of the nose, is responsible for equalizing the pressure within the middle ear. If the Eustachian tube becomes blocked, usually because of an ear infection, a cold or a sinus infection, it can create a negative pressure buildup within the middle ear. This can cause the eardrum to pull apart, creating a pocket. This pocket can fill with waste material (such as old skin cells) and become bigger and bigger. If this pocket gets too big, it can begin causing serious damage to the structure of the ear.
The symptoms of a cholesteatoma typically start out mild and get worse as it grows larger. Symptoms will begin with a foul-smelling discharge from the ear and then move on to feelings of pressure, dizziness and hearing loss. It is important to see your doctor as soon as you are beginning to experience these symptoms; if left untreated the cholesteatoma will just continue to grow larger and cause more damage to the ear.
A review of your medical history and a physical exam using an otoscope, a lighted device used to examine the inside of the ear, is usually all that is needed to diagnose a cholesteatoma. If the cholesteatoma cannot be seen, a CT scan may be ordered.
The first method of treatment to control the growth, treat any infections, reduce inflammation and drain the ear is through an ear cleaning, antibiotics and ear drops. The only way to completely remove the cholesteatoma is through surgery. Usually performed as an outpatient procedure, the first surgical procedure will only remove the growth. A second surgery may be necessary to repair any damage the cholesteatoma caused in the middle ear. Follow up visits will also be needed to make sure the cholesteatoma is not growing back.