An abnormal skin growth in the middle ear behind the eardrum is called Cholesteatoma. Repeated infections or a tear or pulling inward of the eardrum can allow skin into the middle ear. Depending on the procedure, approximately 5-40% of cholesteatoma surgery is unsuccessful. Persistence may appear as early as 5-6 months postoperatively, or it may be delayed for many years. Consequently, close follow-up care is important.
Cholesteatoma grows aggressively. It is a commonly becomes infected because it retains bacteria,. This infection may not go away until the cholesteatoma is completely removed.
Cholesteatoma causes bone erosion which can lead to hearing loss by destroying the small hearing bones that carry sound in the middle ear.
Bone erosion can also lead to more serious complications by allowing the spread of infection outside the middle ear. This infection can:
- Facial nerve paralysis
- Form a bony ulcer
- Inner ear infection causing dizziness or deafness
While these complications are rare, they are very serious and can be prevented by Cholesteatoma Surgery as soon as possible.
Treatment of Cholesteatoma
Although surgery is rarely urgent, once a cholesteatoma is found, surgical treatment is the only choice. Cholesteatoma surgery usually involves a tympanoplasty to repair the eardrum and mastoidectomy to remove the disease from the bone. The exact type of operation is determined by the stage of the disease at the time of surgery.
Cholesteatoma surgery, which is delicate surgery performed under a microscope, usually takes 2 to 3 hours, and patients may go home the same day. It is very important to remove the disease completely, or it may grow back. The rate of re-growth is higher in children than adults. Because of the aggressive nature of cholesteatoma, we ask patients come in regularly for careful follow-up. Sometimes a second surgery will be necessary.
Results of Cholesteatoma Surgery
Surgery results in the complete removal of cholesteatoma in the majority of cases. Hearing loss can often be restored to some degree. If the disease prevents effective hearing restoration, a smaller operation in the future may be the best way to improve your hearing.