A cholesteatoma is an uncommon condition of the middle ear that involves a noncancerous growth of skin cells. Although it is not a tumor in the traditional sense, a cholesteatoma can continue to grow over time and cause damage to surrounding structures in the ear. If left untreated, it may lead to serious complications affecting hearing and balance.
While a cholesteatoma can be present at birth, most cases develop as a result of long standing or recurrent ear infections. The eustachian tube connects the middle ear to the back of the nose and helps regulate pressure within the ear. During an ear infection or ongoing inflammation, the eustachian tube can become blocked. This blockage creates negative pressure in the middle ear, which can cause part of the eardrum to be pulled inward.
Over time, this inward pocket can trap dead skin cells, fluid, and other debris. As this material accumulates, it forms a cyst like growth known as a cholesteatoma.
Other factors that may contribute to eustachian tube dysfunction and increase the risk of developing a cholesteatoma include sinus infections, frequent colds, and allergies.
At ENT Specialists of Alberta, our team provides expert assessment and treatment for middle ear conditions, helping patients across Alberta receive timely care and prevent long term complications.
In the early stages, a cholesteatoma may cause only mild or subtle symptoms, as the growth is small. As it continues to enlarge and affect nearby structures in the ear, symptoms may become more noticeable and can include:
• Foul smelling discharge from the affected ear
• A feeling of increased pressure or discomfort inside the ear
• Hearing loss
Cholesteatomas most often develop in one ear, although involvement of both ears can occur in some cases.
If a cholesteatoma continues to grow without treatment, it can lead to more serious symptoms and complications. As the growth expands, it may damage the bones of the middle ear, the eardrum, or the facial nerve. This can result in dizziness or vertigo, facial weakness or paralysis, and permanent hearing loss. Although rare, severe complications may include brain abscess or meningitis, which are serious and potentially life threatening conditions.
Diagnosis of a cholesteatoma may begin with an examination by your family physician or an ear nose and throat specialist. Using an otoscope to look inside the ear, the provider can assess the middle ear for signs of a cholesteatoma or cyst.
If the physical examination does not provide a clear diagnosis, additional imaging such as a CT scan may be recommended. This is especially important for patients experiencing dizziness or facial weakness, as imaging helps rule out other possible causes.
At ENT Specialists of Alberta, our specialists provide thorough evaluation and timely diagnosis for patients across Alberta with suspected middle ear conditions.
Surgery is the only effective treatment for a cholesteatoma. The procedure is performed under general anesthesia and is typically completed as a day surgery, meaning an overnight hospital stay is usually not required. Because a cholesteatoma does not resolve on its own and can continue to grow, timely surgical removal is important to reduce the risk of damage to nearby ear structures and surrounding areas of the brain.
Surgical treatment for cholesteatoma is generally successful. However, as with any surgical procedure, there are potential risks and complications. These may include:
• Infection at the surgical site
• Pain following the procedure
• Injury to the facial nerve
• Hearing loss
• Dizziness or vertigo
• Changes in taste
• Scarring
If the cholesteatoma has already caused damage to structures within the ear, such as the small bones responsible for hearing, additional procedures may be required to repair or reconstruct these areas. In some cases, a cholesteatoma can recur even after successful removal. If this occurs, further surgery may be recommended to manage the condition.
At ENT Specialists of Alberta, our surgeons are committed to providing expert surgical care and long term follow up to help reduce the risk of recurrence and protect your hearing health.
If you or your child are experiencing ongoing ear discharge, hearing loss, a feeling of ear fullness, or dizziness that may be related to a cholesteatoma, contact ENT Specialists of Alberta today to schedule a consultation and receive timely care.
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