Cholesteatoma
What is a A cholesteatoma (kol-es-tee-a-toe-muh) is a type of skin cyst behind the cholesteatoma? eardrum and in the middle ear space. It can also grow into the bone of the skull right behind the ear (called the “mastoid” bone).
What causes a A child can be born with a cholesteatoma (“congenital”) or get one as a cholesteatoma? complication from having frequent ear infections. Sometimes they can occur after an injury to the eardrum or after eardrum surgery (this is rare) .
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Cholesteatoma
How can Ear infections happen when the fluid behind the eardrum becomes infected. chronic ear Usually the connection between the ear and nose (called the eustachian tube), infections equalizes the pressure behind the eardrum and allows fluid to be absorbed. In cause a many young children, the eustachian tube does not function very well. This leads to chronic negative pressure and fluid behind the eardrum which can cholesteatoma? become infected. Over time, this process can pull part of the eardrum back into the middle ear and create a pocket or cyst. This cyst is filled with old skin cells from the ear drum and other waste material. Over time the cyst can grow and become infected. As the cyst gets bigger, it pushes against the hearing bones in the middle ear space and in time can break them down. This can affect hearing, balance and the function of the face muscles. What are the • Drainage from ear symptoms of a • Decreased hearing cholesteatoma? • Dizziness or change in balance • Ringing in ears • History of recurrent ear infections or repeated bursting of ear drum • Note - Pain in the ear rarely occurs and many cholesteatomas have no symptoms at all
How is a An otolaryngologist (ear, nose and throat doctor) can diagnose a cholesteatoma. cholesteatoma An ear exam usually shows a pocket or perforation (hole) in the ear drum with a diagnosed? cyst behind it. It can be hard to diagnose if the ear drum is draining. Often doctors will prescribe ear drops and antibiotics to control the drainage. Then it is easier to tell if there is a cholesteatoma present or not. If the drainage continues after the patient is put on antibiotics, there is a good chance that a cholesteatoma is present. If a cholesteatoma is suspected, a CT (CAT scan) scan of the middle ear may be done to see how large the cholesteatoma is and whether it has started to erode the hearing bones. We will also give your child a hearing test called an audiogram to test their hearing level before having the cholesteatoma removed. What are the If the cholesteatoma is not treated, it will keep growing. Although it often is slow complications growing, if left untreated it can grow into the mastoid skull bone and can if the eventually lead to a brain infection, meningitis and facial paralysis. Your child cholesteatoma could also have permanent hearing loss and get severe dizziness (vertigo) if the cholesteatoma is not taken care of. is not treated? How are Surgery is needed to remove the cyst. The surgery is called a cholesteatomas tympanomastoidectomy. In this procedure, the surgeon will make a small treated? incision behind the ear and lift the ear forward. Then the surgeon will remove the cyst using a special microscope. If the cyst has surrounded or damaged the hearing bones, one or more of the bones may need to be removed. The surgery takes about 3 to 4 hours. Additional revision surgeries and a special MRI scan are often needed to recheck that the cyst has not regrown. This is often performed 6 to 12 months after the first surgery.
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What if the If the hearing bones are affected by the cholesteatoma, they may be able to be hearing bones reconstructed. If needed, this is done at the time of the second surgery when the are damaged? ear has had time to heal. For some patients, rebuilding the hearing bones does not work or is not an option. If this happens, the patient may be referred to an audiologist for a hearing aid. What can I • Your child will likely go home the same day as the surgery. They will go home expect for my with a bandage around their ear and prescriptions for pain medicine and ear child after drops. Use the medicines only if recommend by your healthcare provider. surgery? Check with your healthcare provider first before giving any type of medicine to your child. • Your child will need to have a follow up visit with the surgeon after the surgery to have some surgical packing gently removed from their ear canal. • Your child will need to be home from school for about one week. • Your child should not swim for at least 6 to 8 weeks after the surgery. Depending on the extent of the cyst and whether the hearing bones were damaged , your child’s hearing may be worse after the surgery , especially if the hearing bones were removed.
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