Cholesteatoma

Cholesteatoma is a condition of the middle ear and mastoid (bone behind the ear) where skin (keratin) builds up in a cyst. This can cause very serious problems in some patients including weakness of the facial muscles, and causing a communication with the brain. More commonly it causes ear infection and smelly discharge, hole in the ear drum, hearing loss, tinnitus and dizziness.

Cholesteatoma is not a cancer but it is important to investigate patients with these symptoms to rule that out as a possibility. The ear will be examined under the microscope in clinic and if cholesteatoma is suspected, a CT scan of the mastoid ear bone is undertaken.

This disease is treated with surgery, which clears the cholesteatoma and reconstructs the ear drum (tympanomastoidectomy). Unfortunately cholesteatoma has a high likelihood of recurrence so patients may need a ‘second-look’ operation at 12 months and/or followup surveillance imaging. Hearing loss after the surgery may need rehabilitation with a hearing aid or further surgery (ossiculoplasty).