Definition

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

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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 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

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

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:

• CT scan
• MRI scan

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 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.

Prevention

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