Auditory System Hearing Disorders Coleasteatoma

A cholesteatoma is a growth in the tympanic membrane (or eardrum) of the middle ear. It can occur when dead skin cells accumulate and lead to infection. This growth (resembling a tumor) in ear structures can lead to discomfort and problems with hearing. Cholesteatomas are treatable, and best outcomes occur if they are found early. Rarely, cholesteatomas can recur, and in severe cases, may lead to permanent hearing damage.

Cholesteatoma - Hearing Disorders

What Causes Cholesteatomas?

Cholesteatoma growth occurs when dead skin cells accumulate in the middle ear and become infected. Cholesteatoma growth has several causes:

  • Dysfunction of the eustachian tube (which regulates air pressure in the middle ear), usually caused by a cold or allergies, can lead to negative air pressure in the ear. This can stretch the tympanic membrane (eardrum), and create a pouch that can accumulate dead skin cells.
  • Perforation of the tympanic membrane can also lead to a pouch that can collect skin cells and form a cholesteatoma.
  • Congenital cholesteatoma is rare, but infants can be born with cholesteatoma growing behind the eardrum.

Symptoms of cholesteatoma can include drainage from the ear, a feeling of fullness in the ear, ear pain, and in more severe cases, temporary or permanent hearing loss.

Cholesteatoma Complications

As it forms on the tympanic membrane, cholesteatoma can affect the hearing mechanism of the middle ear. A healthy tympanic membrane is a thin layer of tightly stretched skin, which vibrates when struck by sound waves. Presence of a cholesteatoma can lead to stiffness or reduced mobility of the tympanic membrane, which impairs the ability of hearing structures to transmit sound information to the inner ear.

If left untreated, a cholesteatoma infection can spread to other ear structures and surrounding areas. This can be accompanied by increasing drainage and ear pain. Tumor-like growth and infection can continue to affect structures including the ossicles (the three small bones of the middle ear), which can cause more permanent hearing damage. Advanced cases of cholesteatoma can even spread to the mastoid process (the bone behind the ear), or to the bony labyrinth of the inner ear, affecting hearing and balance.

Cholesteatoma Treatment

If your doctor suspects you have a cholesteatoma, he may refer you to an otolaryngologist (commonly referred to as an “ear nose and throat doctor,” or ENT). In many cases, the first course of treatment includes ear cleanings and antibiotics. In more severe or advanced cases, cholesteatomas can be treated surgically. Surgery can remove the cholesteatoma itself, and in rare cases, damaged bone. Rechecking the affected ear after treatment is important to monitor for recurrence, with follow-up, if necessary. Early treatment and vigilant monitoring are generally the best courses of action for cholesteatoma.

Resources

American Academy of Otolaryngology-Head and Neck Surgery (n.d.). Cholesteatoma. Retrieved February 9, 2010, from American Academy of Otolaryngology-Head and Neck Surgery Web site: http://www.entnet.org/HealthInformation/cholesteatoma.cfm.

Neurotology Research Center (n.d.). Cholesteatoma. Retrieved February 9, 2010, from earsite.com Web site: http://www.earsite.com/tumors/cholesteatoma.html.