Cholesteatoma, sometimes referred to as a “pearl cyst,” is an abnormal skin growth that occurs in the middle ear behind the eardrum. It is not cancerous but can cause significant problems if left untreated. Cholesteatomas can damage the delicate structures of the middle ear, leading to hearing loss, infection, and other complications. Both adults and children can develop cholesteatomas.
Symptoms
Symptoms of cholesteatoma can vary, but common signs include hearing loss, drainage from the ear, and a feeling of fullness or pressure in the ear. The drainage may have a foul odor. Some individuals may also experience dizziness, ear pain, or tinnitus (ringing in the ear). In severe cases, cholesteatomas can erode the bones of the middle ear, leading to more serious complications such as facial paralysis or brain abscess.
Causes
Cholesteatomas typically develop as a result of chronic ear infections or eustachian tube dysfunction. The eustachian tube connects the middle ear to the back of the throat and helps to equalize pressure in the ear. When the eustachian tube is not functioning properly, it can create negative pressure in the middle ear, causing the eardrum to retract and form a pocket or cyst. Skin cells and other debris can become trapped in this pocket, leading to the formation of a cholesteatoma. In rare cases, cholesteatomas can be congenital, meaning they are present at birth.
Diagnosis
If you or your child experiences symptoms of a cholesteatoma, it’s important to seek medical evaluation. A healthcare provider will examine the ear using an otoscope, a lighted instrument that allows them to visualize the ear canal and eardrum. The doctor will look for signs of a cholesteatoma, such as a white or pearly mass behind the eardrum. Hearing tests may be performed to assess the extent of any hearing loss. In some cases, a computed tomography (CT) scan may be necessary to evaluate the size and location of the cholesteatoma and to assess any damage to the surrounding structures.
Treatment Options
The primary treatment for cholesteatoma is surgery. The goal of surgery is to remove the cholesteatoma and any infected tissue, repair any damage to the middle ear structures, and prevent recurrence. Surgery is typically performed by an otolaryngologist (ENT doctor). Depending on the size and location of the cholesteatoma, surgery may be performed through the ear canal or through an incision behind the ear. In some cases, a second surgery may be necessary to reconstruct the middle ear bones and improve hearing. Following surgery, regular follow-up appointments are essential to monitor for any signs of recurrence.
Prevention
While it’s not always possible to prevent cholesteatomas, there are steps you can take to reduce your risk. Seek prompt medical attention for ear infections and follow your doctor’s recommendations for treatment. Avoid smoking, as it can increase the risk of ear infections. Keep your ears dry by using earplugs when swimming or showering. If you have a history of ear problems, see an otolaryngologist for regular checkups.
Takeaway
Cholesteatoma is a serious ear condition that requires prompt medical attention. Early diagnosis and treatment with surgery can help prevent complications and preserve hearing. Regular follow-up care is essential to monitor for any signs of recurrence.