What Is an Ear Cholesteatoma?

An ear cholesteatoma is a non-cancerous growth that can cause serious complications.

A cholesteatoma is a skin growth in your middle ear behind your eardrum. It starts out as a build-up of skin cells and earwax that then becomes a lump. As skin cells gather, the cholesteatoma grows. Eventually, it can cause infections, drainage, and hearing problems.

Here is information to help you understand what causes a cholesteatoma, what the symptoms are and how it’s found, what the treatment is, and what the dangers are if it goes untreated.

A tube called the eustachian tube connects your middle ear to your nose and sinuses and regulates the pressure in your ear. If it doesn’t work well, you could develop a cholesteatoma. Negative pressure from a eustachian tube that isn’t working the way it should hurts your eardrum. In response, your eardrum pulls back. Skin and earwax then collect in the space where it was and grow into a cholesteatoma. Seasonal allergies, colds, coughs, and sinus infections can cause the eustachian tube problems that can lead to a cholesteatoma.

You can also develop one of these growths after your eardrum is injured in an accident, with an infection, or during surgery. You’re more likely to get one if you have a cleft palate, Down syndrome, or abnormalities in the bones of your face or head.

Rarely, some babies are born with cholesteatomas. When that happens, it can grow for years without symptoms.

Cholesteatomas that develop later in life can cause these symptoms:

• Fluid draining from your ear, often with a bad smell
• Hearing problems
• Pain or pressure in or behind your ear
• Ringing in your ears
• Repeated ear infections
• Dizziness
• Trouble moving your face

The growth usually affects just one ear. Cholesteatomas require medical treatment. If you think you have one, see your doctor.

When you see your doctor about your symptoms, here’s what you can expect.

First, your doctor will examine your ear. He might give you medication for fluid drainage from your ear. If the drainage continues for two weeks after treatment, the doctor may suspect a cholesteatoma. The doctor will also look for changes in your eardrum, especially a white mass behind it.

If your doctor thinks you have a cholesteatoma, he will refer you to an ear, nose, and throat (ENT) specialist, also called an otolaryngologist. Your ENT may give you a hearing test and other tests, like a CT scan or an MRI, to try to see the growth.

You’ll probably need surgery with general anesthesia to remove a cholesteatoma. Your surgeon will remove the skin and the infection. She might also need to rebuild your eardrum or hearing bones or remove bone from behind your ear.

You also might need a second surgery -- usually 6 months to a year after your first one -- to make sure the growth is all gone.

Typically, you can go home the same day you have a cholesteatoma surgery. But, you could need to stay in the hospital overnight. After surgery, your doctor might pack your ear with bandages. You’ll probably need to take 1 to 2 weeks off work. You might also need antibiotics to treat any infections the cholesteatoma caused.

Once you’re home, you’ll need to keep your ear dry. Your doctor will tell you if you shouldn’t fly, swim, or exercise for a few weeks.

You’ll have follow-up appointments, so your doctor can check and clean your ear and test your hearing. Make sure to continue checkups long term to be sure the cholesteatoma hasn’t come back.

Is a Cholesteatoma Serious?

Cholesteatomas damage your eardrum. If they grow, they can hurt your middle ear, your inner ear, and even your brain. This can hurt your hearing, make you dizzy, and damage the nerves in your face. These growths can also cause infections that, if untreated, could spread to your brain.

You can avoid many complications if you catch a cholesteatoma early.