Cholesteatoma

Definition

Cholesteatoma is a type of 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

Long-term swelling in the eustachian tube leads to negative pressure in the middle ear. This pulls a part of the eardrum (tympanic membrane) in 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 cause the some ear bones to waste away.

Symptoms

• Drainage from the ear
• Hearing loss in one ear
• Pain or numbness in the ear or around the ear
• Dizziness

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.

• Electronystagmography
• Caloric stimulation
• CT scan

Treatment

Surgery is needed to remove the cyst.

Outlook (Prognosis)

Cholesteatomas usually continue to grow if not removed. Surgery usually works, but you may need the ear cleaned every once in a way. Additional surgery may be needed if the cholesteatoma recurs.

Possible Complications

• Deafness in one ear
• Dizziness (vertigo)
• Persistent ear drainage
• Erosion into the facial nerve (causing facial paralysis)
• Spread of the cyst into the brain
• Labyrinthitis
• Meningitis
• Brain abscess

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.