Cholesteatoma
What is a cholesteatoma?
Why is skin behind my eardrum a problem?
How did skin end up in my middle ear?
What are the normal symptoms from a cholesteatoma?
Is it cancer?
Is it dangerous?
Uncommon Complications That Can Occur If Left Untreated
Vertigo
Deafness
Facial Weakness
Cerebrospinal Fluid Leak
Meningitis/Brain Abscess
How are cholesteatomas treated?
In order to remove a cholesteatoma, surgery is necessary. Initially, cholesteatomas often present when they are infected, and they are treated with either oral or topical antibiotics. This can alleviate the initial symptoms, yet surgery is still recommended to avoid damage to critical structures in and around the ear.
A CT scan is usually ordered to determine whether the cholesteatoma has eroded any critical structures, such as the inner ear, facial nerve, brain cavity, and to help with surgical planning. Sometimes an MRI is also needed.
What are the goals of surgery?
Safe Ear
Dry Ear
Hearing Ear
What does the surgery entail?
Three Possible Outcomes for the Initial Surgery
Ear Canal Wall Left Intact, Single Surgery
Ear Canal Wall Left Intact, Second Look Surgery Needed in 6-12 Months
The cholesteatoma has been removed, but there is a good chance there are a skin cells left. If only a single skin cell is left in the middle ear, the cholesteatoma will recur. If single cells are left, in 9 months they will grow into pearls which are easily visible and removable in a second look surgery. Hearing would then be reconstructed during the second surgery.
Ear Canal Wall Removal
What are the risks of surgery?
- Anesthesia
- Bleeding
- Dizziness
- Hearing loss – The cholesteatoma itself can often transmit sound itself, so removal can lead to worsened hearing, particularly the hearing bones cannot be reconstructed during the first surgery. There is also a risk of total deafness in the ear following surgery if the cholesteatoma is invading inner ear structures (rare).
- Recurrence – If a single skin cell is left after the final surgery with the ear canal wall left intact, the cholesteatoma can come back in the future.
- Facial nerve injury – This is uncommon but possible, particularly in severe cholesteatomas because they can eat away the bone surrounding the facial nerve.
- Cerebrospinal fluid leak – This can occur if the cholesteatoma erodes away the bone under the brain.
Schedule Your Appointment!
Please call us at 815-725-1191 to schedule an appointment.