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Cholesteatoma

Definition

A cholesteatoma is a type of cyst found in the middle ear behind the eardrum. It is a noncancerous tumor.

Regions of the Ear
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Causes

A cholesteatoma forms when the skin grows through the hole in the middle of the ear. It can occur due to a damaged eardrum or a defect at birth.

Risk Factors

Factors that increase your risk of a cholesteatoma include:

  • Chronic ear infections
  • A poorly functioning eustachian tube
  • Down syndrome
  • Turner syndrome
  • Cleft palate
  • Abnormalities of the bones of the skull and face
  • A family history of chronic middle ear disease or cholesteatoma

Symptoms

Symptoms include:

  • Hearing loss
  • Discharge from the ear, sometimes foul-smelling
  • Pressure in the ear
  • Earache
  • Numbness of the ear
  • A sensation of spinning when you are not moving
  • Muscle weakness in the face on the affected side

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually made based on visual symptoms.

Images may be taken of your middle ear and surrounding structures. This can be done with:

Your nerve function may be tested. This can be done with:

  • Hearing tests and balance tests
  • Electronystagmography
  • Caloric stimulation

Treatment

Cholesteatoma is a serious medical problem. Early treatment is vital for the best outcome. Serious complications may occur if the tumor goes untreated, including hearing loss , muscle weakness, and a sensation of spinning known as vertigo . If the infection spreads to the brain it can lead to meningitis and brain abscess.

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

Surgery

Surgery prevents complications such as hearing loss and balance problems. Thorough cleaning of the ear is necessary to remove fluid and bacteria. It is done with a scalpel or a needle and a syringe. Eardrops are also usually given to prevent the infection from returning.

Medications

Medications are necessary to dry the fluid in the ear if allergies or other causes are producing excess fluid.

Prevention

Cholesteatomas caused by defects at birth cannot be prevented. However, proper treatment and close follow-up of ear infections can help prevent cholesteatoma.

Revision Information

  • Family Doctor—American Academy of Family Physicians

    http://familydoctor.org

  • Healthy Children—American Academy of Pediatrics

    http://www.healthychildren.org

  • About Kids Health—The Hospital for Sick Children

    http://www.aboutkidshealth.ca

  • Health Canada

    http://www.hc-sc.gc.ca

  • Cholesteatoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 27, 2013. Accessed September 11, 2014.

  • Cholesteatoma. ENT Health Information: Ears. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/HealthInformation/cholesteatoma.cfm. Updated March 2011. Accessed September 11, 2014.

  • Levenson M. Cholesteatoma. Ear Surgery Information Center website. Available at: http://www.earsurgery.org/cholest.html. Accessed September 11, 2014.

  • 4/29/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Angtuaco EJ, Wippold FJ. American College of Radiology (ACR) Appropriateness Criteria for hearing loss and/or vertigo. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/HearingLossVertigo.pdf. Updated 2013. Accessed September 11, 2014.