Cholesteatoma – an example of a condition that is very difficult to spot. It is often symptomless until it becomes more significant in size. If unchecked it can cause serious hearing and health problems. When we see the condition in our practice, it results in an immediate ENT referral. A Cholesteatoma is an abnormal collection of skin cells that gather inside your ear.
The diagram demonstrates how difficult the condition is to detect but if left
untreated, this benign growth can continue to develop and damage the delicate structures deep inside your ear. Over time it can have a devastating effect on hearing and balance.
A Cholesteatoma can cause serious ear infection, which can produce discharge from the ear and in most cases hearing loss (which can be permanent), vertigo (extreme dizziness), tinnitus (ringing in the ear) and even damage to the facial nerve, causing weakness in half your face. In very rare cases, an infection can spread into the inner ear and brain, leading to a brain abscess or meningitis. Cholesteatoma normally only affects one ear. Early warning signs are often difficult to spot but can include discharge, which is often smelly and persistent. It can start to gradually affect hearing in that ear and people sometimes describe a feeling of fullness and discomfort.
It can often be symptomless and you are only aware of it after visual inspection. A cholesteatoma can develop if part of the eardrum collapses because of problems with the Eustachian tube (the connection between the ear, nose and throat).
A Cholesteatoma can also occur after the eardrum has been damaged through an injury or infection. It is possible to be born with a Cholesteatoma as a result of the structures within the ear developing abnormally. To confirm that you have a Cholesteatoma, an ENT surgeon will examine your ear and may organise a CT scan to see which parts of your ear are affected and to decide whether treatment is undertaken.
Treatment may include surgery if developing slowly and the location is not deemed high risk you may find that no treatment is necessary except regular check-ups and most importantly keeping the ear dry in all circumstances (using plugs in the shower etc).