Cholesteatoma refers to a growth of squamous cells ( skin cells) which arise from the middle ear or mastoid. They grow progressively over years causing erosion of the ear drum, middle ear bones, balance canals and chorda tympani nerve which governs our taste. Extensive cases erode the facial nerve which is in charge of hemi-facial movement and the tegmen which is a plate of bone separating the ear from the brain.
There are 3 main types of cholesteatomas that you may experience, each with a different root cause:
- Primary acquired: this type of cholesteatoma occurs when the underlying problem is eustachian dysfunction.
- Secondary acquired: this occurs when skin cells accumulate in the middle ear and mastoid in the presence of a perforated ear drum, or if there was previous ear surgery.
- Congenital: this occurs when skin cells accumulate and get trapped in the middle ear before birth. These are present in the affected child at birth.
Symptoms of Cholesteatoma:
- Ear discharge
- Gradual hearing loss
- Vertigo or dizziness
- Facial palsy
- Brain infections
Cholesteatomas are commonly misdiagnosed and only detected late. Hence it is important that you seek treatment from an Otologist who is an ENT doctor subspecializing in ear disorders.
Diagnosis is mainly clinical but a CT scan is essential to evaluate the extent of the cholesteatoma and if there are any impending complications.
Hearing and balance tests are also warranted.
The priority of the surgery is to remove the cholesteatoma tumour completely with no spillage. If there are complications, attempt will be made to repair the complication. Hearing reconstruction is almost always concurrently attempted but takes back seat to complete tumour removal. Post-surgery, the patient will need to be followed-up for a few years to monitor for cholesteatoma recurrence.