Cholesteatoma is a middle ear cyst that can cause serious complications such as hearing loss, meningitis, or brain abscess. It can be caused by chronic ear infections and requires immediate treatment, which may include surgery. Failure to treat it can lead to damage to the bones of the ear and the brain. Diagnosis is done through an ear exam and culture of ear contents.
A cholesteatoma is a middle ear cyst that can have very serious complications. While the cyst may remain low-grade in some patients, with no long-term consequences, in others it can lead to problems such as hearing loss, meningitis or a brain abscess. Given these serious complications, it is important to treat a cholesteatoma when it is identified as a potential threat.
There are a number of circumstances in which a cholesteatoma can form. Some are congenital, while others form due to chronic ear infections. In all cases, the cyst includes dead skin cells and chunks of cholesterol that can’t drain out of the ear. It can become infected with bacteria, causing a strong smelling discharge. The patient also feels numbness and pain in the ear and may experience some hearing loss.
Immediate treatment for cholesteatoma is an ear cleaning, in which a doctor goes in to flush out dead, infected material. In some cases, this may be enough to address the problem; Sometimes the cyst just needs a little help draining and cleaning. In other cases, surgery may be needed to actually remove the cyst. During surgery, the area may also be evaluated for any signs of long-term damage.
Surgery may not always be recommended. The need for surgery depends on the patient and the situation, and a doctor will not recommend it unless it is necessary. Patients who are unsure about the need for surgery may request an appointment with an ear, nose and throat specialist for a second evaluation.
The problem with a cholesteatoma is that if the infection persists, it can start eating into the bones of the ear, disrupting the complicated and delicate system used for hearing. The infection can also migrate to the brain which is, as one might imagine, highly undesirable. While the brain is normally adept at protecting itself from infection with the use of barrier materials, when infection reaches the brain, it can cause serious damage.
This condition can be diagnosed with an ear exam in which a doctor visually examines the ear. The cholesteatoma can be seen inside the ear, and the doctor may also take a swab so the ear contents can be cultured. Certain types of bacteria are particularly fond of cholesteatomas, and their presence can be a red flag that a cholesteatoma is present in the ear.
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