Cholesteatoma
Definition
Cholesteatoma is a type of skin cyst located in the middle ear.
Causes
Cholesteatoma can be a birth defect (congenital), but it more commonly occurs as a complication of chronic ear infection.
Poor function in the eustachian tube leads to negative pressure in the middle ear. This pulls a part of the eardrum (tympanic membrane) the wrong way, creating a sac or cyst that fills with old skin cells and other waste material. The cyst becomes infected. The cyst may get bigger and break down some of the middle ear bones, affecting hearing.
Symptoms
- Dizziness
- Drainage from the ear
- Hearing loss in one ear
- Pain or numbness in or around the ear
Exams and Tests
An ear exam may show a pocket or perforation (opening) in the eardrum, often with drainage. The deposit of old skin cells may be visible with an otoscope, a special instrument to view the ear.
The following tests may be performed to rule out other causes of dizziness.
Treatment
Surgery is needed to remove the cyst.
Outlook (Prognosis)
Cholesteatomas usually continue to grow if not removed. Surgery usually works, but you may occasionally need the ear cleaned by a health care provider. Additional surgery may be needed if the cholesteatoma comes back.
Possible Complications
- Brain abscess
- Deafness in one ear
- Dizziness (vertigo)
- Erosion into the facial nerve (causing facial paralysis)
- Labyrinthitis
- Meningitis
- Persistent ear drainage
- Spread of the cyst into the brain
When to Contact a Medical Professional
Call your health care provider if ear pain, drainage from the ear, or other symptoms occur or worsen, or if hearing loss occurs.
Prevention
Prompt and complete treatment of chronic ear infection may help to prevent some cases of cholesteatoma.
References
Smith JA, Danner CJ. Complications of chronic otitis media and cholesteatoma. Otolaryngol Clin North Am. 2006; 39(6):1237-55.
Reviewed By: Alan Lipkin, MD, Otolargyngologist, private practice, Denver, CO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
