At Stanford Health Care Ear, Nose, and Throat, we treat people from around the world with cholesteatomas. Our skilled surgeons specialize in removing cholesteatomas with advanced surgical techniques and restoring your hearing as much as possible.
What is a cholesteatoma?
A cholesteatoma is a growth inside the ear. It’s a type of skin cyst (a pouch of tissue beneath the skin). The pouch is filled with skin cells and often fluid.
The growth is not a tumor or cancer, but it can damage your ear. Over time, trapped skin cells keep dividing and growing, and the cyst gets bigger. The cyst grows faster and causes more harm if it becomes infected.
Where do cholesteatomas grow?
A cholesteatoma develops in your eardrum or middle ear, and can lead to damage of the hearing and middle ear bones from inflammation. It can grow into your mastoid (the bone behind your ear) if left untreated. The ear cyst can harm other nearby structures, including your inner ear, face, neck, and (in rare cases) brain. Untreated cholesteatomas are at high risk for infection, and can even lead to meningitis or facial paralysis.
What causes a cholesteatoma?
We don’t fully understand why a cholesteatoma develops. Sometimes, the cyst is present from birth (congenital). Other times, ear injuries such as eardrum rupture (tympanic membrane perforation) can lead to cholesteatomas.
Eustachian tube dysfunction may be a risk factor cholesteatomas by creating negative pressure in the middle ear space, but this is not always the case.
How common are cholesteatomas?
This benign ear cyst develops in about 1 in 20,000 people.
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Cholesteatoma sometimes can be found by your doctor looking in your ear with minimal symptoms. In other cases, symptoms can include:
- Ear drainage and infection
- A sense of fullness or pressure in your ear
- Balance problems
- Changes in your ability to taste
- Ear pain
- Hearing loss
- Ringing in your ear (tinnitus)
- Weakness in your face
Types of Cholesteatomas
A benign ear cyst may be present from birth, which is called congenital cholesteatoma. More commonly, it can develop later in life from a problem inside your ear. This type is called acquired cholesteatoma.
Preventing Sensorineural Hearing Loss
Sensorineural hearing loss may develop for reasons out of your control. However, you can prevent inner ear damage from certain causes. Be sure to:
- Ask your doctor if alternatives exist for medications known to be ototoxic (harmful to the ears).
- Treat viral infections as soon as possible.
- Reduce your exposure to loud noises, such as noise from music, lawn mowers, or power tools.
- Wear ear protection around loud sounds when possible.
Risk Factors for Cholesteatomas
Risk factors are things that increase your chances of having a cholesteatoma. Men have a slightly higher risk for acquired cholesteatoma than women. Other risk factors include:
- A history of needing an ear ventilation tube as a child
- Eardrum rupture (tympanic membrane perforation)
- Eustachian tube dysfunction
Multiple ear infections (otitis media), especially during childhood
Our skilled ear, nose, and throat (ENT) specialists diagnose a cholesteatoma during an office visit. Early diagnosis is key to preventing serious complications and damage from the ear cyst. We may do several tests to get more information about the cholesteatoma and any side effects it causes.
We look inside your ear using a lighted device called an otoscope. An ear microscope can also give us a closer look. We’ll examine your ear canal, eardrum, and middle ear for signs of a cholesteatoma.
A hearing specialist called an audiologist will do hearing tests to check if you have hearing loss from the cholesteatoma. Hearing tests look at your response to several aspects of sound, such as tone, pitch, and loudness.
You may get tests done to check your balance if a cholesteatoma has caused difficulty balancing or damaged your inner ear. These tests measure your:
- Ability to balance while standing
- Eye movements
- Head and neck muscle responses to sound
Your doctor may order imaging tests to check the size of the cholesteatoma and see which nearby structures it affects. These tests could include a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan.
Cholesteatoma (benign ear cyst) is a growth inside your ear. It starts in your eardrum or middle ear, causing inflammation and damage to nearby structures.
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