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Cholesteatoma Pronounced: koh-lee-stee-ah-TOH-mah by Diana Kohnle En Español (Spanish Version) Definition A cholesteatoma is a type of cyst found in the middle ear behind the eardrum. Cholesteatoma is a noncancerous tumor that forms when the skin of a punctured eardrum grows through the hole in the middle ear. If there is an ear infection, the skin will continue to grow into a cholesteatoma. While the tumors are benign, the growths can cause damage to the ears by destroying bones in the ear and causing hearing problems. The tumors may also cause nerve damage, hearing loss, deafness, dizziness, and balance problems. Cholesteatoma is a serious medical problem, and early treatment is crucial for the best outcome. Serious complications may occur if the tumor goes untreated, including destruction of both the middle ear structures causing hearing loss, and inner ear structures causing vertigo (feeling of spinning or whirling). Spreading of infection to the brain can lead to meningitis and brain abscess. Cholesteatoma responds well to treatments. Patients are likely to recover fully without complications if the tumor is caught and treated early. Regions of the Ear © 2011 Nucleus Medical Media, Inc. Causes Cholesteatomas are most often caused by: Ear infections Congenital defects Poorly functioning eustachian tube Page 1 of 3 Copyright © 2011 EBSCO Publishing. All rights reserved. Risk Factors A risk factor is something that increases your chance of getting a disease or condition. Chronic ear infections increase your chance of developing cholesteatoma. Symptoms Symptoms include: Discharge from the ear, sometimes foul-smelling Pressure in the ear Hearing loss Earache Numbness of the ear Dizziness Muscle weakness in the face on the affected side Diagnosis Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include the following: Hearing tests Balance tests CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body Electronystagmography—used to test the function of the nerves related to hearing Caloric stimulation—a test which diagnoses nerve damage to the ear X-ray —a test that uses radiation to take a picture of structures inside the body Treatment Talk with your doctor about the best treatment plan for you. Treatment options include: Cleaning Thorough cleaning of the ear is necessary to remove fluid and bacteria. Eardrops are also usually administered. Surgery Surgery may be necessary if the tumor is threatening hearing or balance. Medications Medications are necessary to dry up the fluid in the ear and include ear drops and oral antibiotics. Antibiotics are prescribed to eliminate any infection in the ear. Page 2 of 3 Copyright © 2011 EBSCO Publishing. All rights reserved. Prevention Cholesteatomas caused by congenital defects cannot be prevented. However, proper treatment of ear infections can prevent cholesteatoma. RESOURCES: American Academy of Pediatrics http://www.aap.org/ American Academy of Family Physicians http://www.aafp.org/ CANADIAN RESOURCES: About Kids Health http://www.aboutkidshealth.ca Health Canada http://www.hc-sc.gc.ca/index_e.html/ REFERENCES: Cholesteatoma. ENT Health Information: Ears. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/healthinfo/ears/cholesteatoma.cfm . Accessed June 27, 2007. DynaMed Editorial Team. Cholesteatoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 15, 2010. Accessed October 29, 2010. Levenson M. Cholesteatoma. Ear Surgery Information Center website. Available at: http://www.earsurgery.org/cholest.html . Accessed June 27, 2007. Last reviewed September 2011 by Elie Edmond Rebeiz, MD, FACS Last Updated: 9/1/2011 Page 3 of 3 Copyright © 2011 EBSCO Publishing. All rights reserved.