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Cholesteatoma

Pronounced: koh-lee-stee-ah-TOH-mah

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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Copyright © Nucleus Medical Media, Inc.

Causes    TOP

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    TOP

Factors that increase your chance of a cholesteatoma include:

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

Symptoms    TOP

Often there are no symptoms. When present symptoms may 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—vertigo
  • Muscle weakness in the face on the affected side

Diagnosis    TOP

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    TOP

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 vertigo. If there is infection it may spread to the brain leading 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    TOP

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

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org
Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

About Kids Health—The Hospital for Sick Children
http://www.aboutkidshealth.ca

References:

Cholesteatoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115151/Cholesteatoma. Updated January 12, 2016. Accessed August 22, 2017.
Cholesteatoma. ENT Health Information: Ears. American Academy of Otolaryngology—Head and Neck Surgery website. Available at:
...(Click grey area to select URL)
Accessed August 22, 2017.
Levenson M. Cholesteatoma. Ear Surgery Information Center website. Available at:
...(Click grey area to select URL)
Accessed August 22, 2017.
4/29/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115151/Cholesteatoma: Angtuaco EJ, Wippold FJ, et al. American College of Radiology (ACR) Appropriateness Criteria for hearing loss and/or vertigo. Available at:
...(Click grey area to select URL)
Updated 2013. Accessed September 11, 2014.
Last reviewed September 2017 by EBSCO Medical Review Board Michael Woods, MD FAAP
Last Updated: 9/11/2014

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