Cholesteatoma is a destructive and expanding growth of cysts (filled with fluid) inside the skin in the middle ear and/or mastoid process.
SIGNS & SYMPTOMS OF CHOLESTEATOMA
- Ear discharge
- Hearing loss in the affected ear
- Swimmer’s ear, inflammation of the ear canal
- Balance disorder
- Tinnitus; ringing in the ear
- Facial nerve weakness
- Bleeding from the ear
- Damage to the ear ossicles
- Nerve damage
- Loss of hearing
- Erosion of the thin bone layer that separates the top of the ear from the brain
- The covering of the bone is left open to infection
- Brain abscess
- HPV infection.
CAUSES & RISK FACTORS OF CHOLESTEATOMA
- Congenital cholesteatoma:
- Middle ear epidermal cysts, identified within the intact ear drum.
- Grow medial to the ear drum.
- No previous history of perforation, discharge or ear surgery.
- Hereditary factors.
- Acquired cholesteatoma:
- Keratin accumulates in the pouch of the ear drum which can extend to middle ear space.
- Under the influence of ear infection
- In the form of retraction pockets which can lead to formation of cholesteatoma.
- Epithelium from the outer ear drum grows into the middle ear through a pre-existing perforation.
- Can also arise due to metaplasia of the middle ear mucosa
- Implantation following trauma.
- Physical examination of the ear and the ear canal by an ENT specialist. Noting presence of symptoms like imbalance, ear pain, discharge, tinnitus, etc.
- CT scan of the ear and neighboring bones & tissues. Images are produced which are studied for ruling out presence of any other serious disease.
- MRI done of the ear and brain for detection of damage, if any, to the brain, auditory nerves & cranial nerves & for assessment of damage to the ear.
TREATMENT FOR CHOLESTEATOMA
The treatment for cholesteatoma usually involves surgical procedures. No medications are available to treat this conditions.
- Mastoidectomy: Procedure is performed to remove the mastoid cells in the skull near the inner ear.
- Tympanoplasty: After a surgical procedure to treat cholesteatoma, certain damage to the ear drum occurs. This damage is assessed & is corrected by reconstruction of the ear canal wall by use of cartilage, fascia, titanium as well as by using the original ear canal skin.
- Surgical removal of the ear ossicles due to them being exposed after a mastoidectomy. Exposed ear ossicles are prone to infection.