Cholesteatoma

A cholesteatoma consists of squamous epithelium that is trapped within the skull base and that can erode and destroy important structures within the temporal bone. Its potential for causing central nervous system (CNS) complications (eg, brain abscess, meningitis) makes it a potentially fatal lesion

Middle ear skin developing

behind the eardrum is called cholesteatoma. Regular infections and/or a tear or in drawing of the eardrum can let skin into the middle ear.

Causes

A cholesteatoma typically occurs from deranged Eustachian tube function or a middle ear infection. Once the Eustachian tubes works poorly, maybe owing to allergy, or sinusitis, the air in the middle ear is absorbed by the body, producing a vacuum in the ear.

The vacuum pressure draws the ear drum in as a pouch or sac,particularly areas weakened by earlier infections. This can develop into a cholesteatoma.

Symptoms and dangers

The ear may drain fluid with a foul stench. As the cholesteatoma pouch or sac widens, it can cause a feeling of fullness or ear pressure, along with hearing loss. Pain behind or in the ear, particularly at night, may cause major discomfort.

Treatment

Surgery is performed under general anesthesia in most cases. The primary purpose of the surgery is to remove the cholesteatoma and infection and achieve an infection-free, dry ear. Hearing preservation or restoration is the second goal of surgery. In cases of severe ear destruction, reconstruction may not be possible. Facial nerve repair or procedures to control dizziness are rarely required. Reconstruction of the middle ear is not always possible in one operation; and therefore, a second operation may be performed six to twelve months later. The second operation will attempt to restore hearing and, at the same time, inspect the middle ear space and mastoid for residual cholesteatoma. Ear cholesteatomas can be dangerous and should never be ignored. Bone erosion can cause the infection to spread into the surrounding areas, including the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and rarely death can occur.