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  • Diana Kohnle
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A cholesteatoma is a type of cyst found in the middle ear behind the eardrum. It is not a cancerous tumor.
Regions of the Ear.

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A cholesteatoma forms when a skin growth grows through a hole in the wall of the middle ear chamber behind the ear drum. It can happen due to a damaged eardrum or an issue that is present at birth.

Risk Factors

Things that can raise the risk of a cholesteatoma include:

  • Chronic ear infections
  • A Eustachian tube that does not work well
  • A family history of chronic middle ear disease or cholesteatoma
  • Down syndrome
  • Turner syndrome
  • Cleft palate
  • Problems with the bones of the skull and face


Often there are no symptoms. When there are symptoms, a person may have:

  • 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


The doctor will ask about symptoms and medical history. A physical exam will be done. Diagnosis is usually made based on this exam.

Images may be taken of the middle ear and surrounding structures. This can be done with:

Nerve function may also be tested. This can be done with:

  • Hearing tests and balance tests
  • Electronystagmography
  • Caloric stimulation


Cholesteatoma is a serious medical problem. Early treatment is vital for the best outcome. Serious problems may happen if the tumor is not treated, including hearing loss, muscle weakness, and vertigo. If there is an infection it may spread to the brain. This could lead to meningitis and brain abscess.

Cholesteatoma responds well to surgical treatment. Patients are likely to recover fully without problems if the tumor is caught and treated early with surgery.


Cholesteatomas caused by defects at birth cannot be prevented.

Proper treatment and close follow-up of ear infections can help prevent cholesteatoma.


Surgery prevents problems such as hearing loss and balance problems. Thorough cleaning of the ear is needed to remove fluid and bacteria. This is done with a scalpel or a needle and a syringe. Eardrops are also often given to prevent the infection from returning.





  • Angtuaco, E.J., Wippold, F.J., et al. American College of Radiology (ACR) appropriateness criteria for hearing loss and/or vertigo. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/HearingLossVertigo.pdf.
  • Cholesteatoma. EBSCO DynaMed website. Available at: http://www.dynamed.com/condition/cholesteatoma.
  • Cholesteatoma. ENT Health Information: Ears. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/cholesteatoma.
  • Levenson, M. Cholesteatoma. Ear Surgery Information Center website. Available at: http://www.earsurgery.org/conditions/cholesteatoma.
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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.