Good hearing is something many people take for granted until something goes wrong. One of the lesser-known but serious ear problems is cholesteatoma. Although the name sounds complicated, it’s important to know what a cholesteatoma is and why timely recognition and treatment are so crucial. In this blog, you’ll read all about the causes, symptoms and treatments so you’re well informed.
What is a cholesteatoma?
A cholesteatoma is a benign but potentially harmful accumulation of skin cells in the middle ear. These skin cells grow in a type of sac or cyst, usually behind the eardrum. Although the word “benign” sounds reassuring, a cholesteatoma can do a lot of damage to important structures in and around the ear if not treated in time.
What many people do not know is that because of its growth, a cholesteatoma can affect bone structures such as the ossicles and even spread toward the balance organ or brain. This makes it a serious condition that should not be ignored.
How does a cholesteatoma occur?
There are several ways a cholesteatoma can develop:
- Acquired cholesteatoma: This is the most common form and usually results from chronic inflammation or malfunctioning Eustachian tube. Prolonged negative pressure in the middle ear can cause the eardrum to pull inward and form a sac in which skin cells accumulate.
- Congenital cholesteatoma: Sometimes a cholesteatoma is already present at birth. In this case, it is skin cells that have developed in the wrong place during the embryonic stage.
Although congenital cholesteatoma is rare, acquired cholesteatomas are relatively common, especially in people with recurrent ear infections.
Who is at risk?
Anyone can develop a cholesteatoma, but certain groups have an increased risk:
- People with chronic middle ear infections
- People with a malfunctioning Eustachian tube
- Children, especially if they suffer a lot from ear infections
- People who have previously undergone surgery on the ear
Symptoms of a cholesteatoma
A cholesteatoma often develops slowly, so symptoms may initially be vague. Typical symptoms include:
- Hearing loss: Due to deterioration of the ossicles or blockage of the middle ear.
- Persistent ear infection: often with a foul-smelling discharge from the ear (runny ear).
- Pressure sensation or pain: The growth of the cholesteatoma causes pressure in the ear.
- Dizziness or balance disorders: If the cholesteatoma reaches the balance organ.
- Muscle weakness in the face: If the facial nerve is affected, it can lead to paralysis of the facial muscles on one side.
Do you recognize these symptoms? Then it is wise to seek medical help quickly. A hearing test can help identify the degree of hearing loss, and an ENT doctor can perform follow-up tests.
Complications of failure to treat
Without treatment, a cholesteatoma can cause serious complications:
- Loss of hearing: Due to irreparable damage to the ossicles.
- Balance problems: Due to impairment of the inner ear.
- Facial palsy: Due to damage to the facial nerve.
- Infections: A cholesteatoma can lead to serious infections such as meningitis or a brain abscess.
This emphasizes how important it is to diagnose and treat it early.
Diagnosis: how is a cholesteatoma diagnosed?
A cholesteatoma can usually be detected by a combination of:
- Ear examination (otoscopy): The doctor looks inside the ear with a special lamp and microscope.
- Hearing test (audiometry): This identifies hearing loss.
- Imaging: Sometimes a CT scan or MRI are needed to assess the extent of the cholesteatoma and damage to surrounding structures.
As an audiologist, a comprehensive hearing test can provide important initial clues. Based on these results, a physician can initiate further investigation.
Treatment of a cholesteatoma
A cholesteatoma cannot disappear on its own. The only effective treatment is surgery, in which it is completely removed. Surgery is usually performed under general anesthesia.
Sometimes a second surgery is needed to check that no residual tissue has been left behind, because a cholesteatoma can grow back. In some cases, the surgery also attempts to restore hearing by replacing or reconstructing the damaged ossicles (ossiculoplasty).
Recovery and aftercare
Surgery is followed by a recovery period in which the ear must heal properly. Hearing loss that occurred before surgery can sometimes improve, but this is not always the case. Regular monitoring by an ENT specialist remains necessary to prevent recurrence.
Life after a cholesteatoma
A cholesteatoma, if treated properly, can heal completely. Nevertheless, permanent hearing loss may occur. In that case, a hearing care professional can help improve hearing, such as with an appropriate hearing aid.
In addition, it is important to stay alert for signs of recurrence. Annual checkup appointments are often part of the aftercare process.
Hearing protection and prevention
Although a cholesteatoma is not always preventable, you can reduce the risk of complications by taking good care of your ears:
- Treat ear infections promptly.
- Always have ears that keep “walking” checked.
- Avoid cotton swabs and other objects in the ear.
- Use hearing protection in noisy environments to prevent eardrum damage.
Proper education and preventive care can prevent many problems – and that’s where an audiologist plays an important role.
Conclusion
A cholesteatoma is a benign but potentially dangerous condition that requires prompt action. By recognizing the symptoms early and seeking medical attention, serious damage can be prevented. For permanent hearing loss after treatment, an audiologist offers help with appropriate hearing solutions.
Take good care of your ears – they are worth it!
