Cholesteatoma

Cholesteatoma is an abnormal skin growth in the middle ear behind the eardrum, and while uncommon in the general population, it can be difficult to detect in its early stages. The growth is usually painless, and it may occasionally be identified during a routine exam. In some cases, it is discovered after prolonged ear drainage or a noticeable decline in hearing. Receiving a cholesteatoma diagnosis can be stressful for both the patient and their family, as clear information can be hard to come by. However, while surgery is typically required, most patients experience good long-term outcomes.

Some children are born with a cholesteatoma. During early fetal development, a small patch of skin may fail to migrate to the outside of the eardrum and instead grows within the middle ear. These congenital or primary cholesteatomas are often identified during physical exams in preschool or elementary-aged children, even if they have little to no history of ear problems.

Cholesteatoma can also develop as a result of chronic ear issues, such as long-standing eustachian tube dysfunction. This can lead to the formation of a pocket or cyst that traps old skin cells, creating a cholesteatoma. In cases where there is a hole in the eardrum, the body typically repairs it, but occasionally, skin cells will grow inward instead of across the drum, leading to the development of a cholesteatoma.

Symptoms of cholesteatoma include chronic ear drainage and gradual hearing loss. In rare cases, it may be discovered during an ear infection or when ear tubes are placed.

Cholesteatomas will continue to grow unless they are surgically removed or their growth is controlled to prevent serious complications. If untreated, this growth can eventually affect hearing, balance, facial nerve function, or cause more severe problems. Fortunately, surgical treatment is highly effective in preventing nearly all complications, though there are no non-surgical options available.