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Cholesteatoma

Chronic ear infection - cholesteatoma; Chronic otitis - cholesteatoma

 

Cholesteatoma is a type of skin cyst that is located in the middle ear and mastoid bone in the skull.

Causes

 

Cholesteatoma can be a birth defect (congenital). It more commonly occurs as a result of chronic ear infection.

The eustachian tube helps equalize pressure in the middle ear. When it is not working well, negative pressure can build up and pull part of the eardrum (tympanic membrane) inward. This creates a pocket or cyst that fills with old skin cells and other waste material.

The cyst may become infected or get bigger. This can cause the breakdown of some of the middle ear bones or other structures of the ear. This can affect hearing, balance, and possibly the function of the facial muscles.

 

Symptoms

 

Symptoms include:

  • Dizziness
  • Drainage from the ear, which can be chronic
  • Hearing loss in one ear

 

Exams and Tests

 

An ear exam may show a pocket or opening (perforation) in the eardrum, often with drainage. A deposit of old skin cells may be seen with a microscope or an otoscope -- a special instrument to view the ear. Sometimes a group of blood vessels may be seen in the ear.

The following tests may be performed to rule out other causes of dizziness:

  • CT scan
  • Electronystagmography

 

Treatment

 

Cholesteatomas very often continue to grow if they are not removed. Surgery is most often successful. However, you may need the ear cleaned by a health care provider from time to time. Another surgery may be needed if the cholesteatoma comes back.

 

Possible Complications

 

Complications may include:

  • Brain abscess (rare)
  • Erosion into the facial nerve (causing facial paralysis)
  • Meningitis
  • Spread of the cyst into the brain

 

When to Contact a Medical Professional

 

Call your provider if ear pain, drainage from the ear, or other symptoms occur or worsen, or if hearing loss occurs.

 

Prevention

 

Prompt and thorough treatment of chronic ear infection may help prevent cholesteatoma.

 

 

References

Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 139.

O'Handley JG, Tobin EJ, Shah AR. Otorhinolaryngology. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier; 2016:chap 18.

 
  • Tympanic membrane

    Tympanic membrane - illustration

    The tympanic membrane is also called the eardrum. It separates the outer ear from the middle ear. When soundwaves reach the tympanic membrane they cause it to vibrate. The vibrations are then transferred to the tiny bones in the middle ear. The middle ear bones then transfer the vibrating signals to the inner ear. The tympanic membrane is made up of a thin connective tissue membrane covered by skin on the outside and mucosa on the internal surface.

    Tympanic membrane

    illustration

    • Tympanic membrane

      Tympanic membrane - illustration

      The tympanic membrane is also called the eardrum. It separates the outer ear from the middle ear. When soundwaves reach the tympanic membrane they cause it to vibrate. The vibrations are then transferred to the tiny bones in the middle ear. The middle ear bones then transfer the vibrating signals to the inner ear. The tympanic membrane is made up of a thin connective tissue membrane covered by skin on the outside and mucosa on the internal surface.

      Tympanic membrane

      illustration

    Tests for Cholesteatoma

     

       

      Review Date: 5/25/2016

      Reviewed By: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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