Summary about Disease
Cholesteatoma is an abnormal, noncancerous skin growth that develops in the middle ear, behind the eardrum. It often starts as a cyst or sac that sheds layers of old skin. Over time, this accumulation can increase in size and potentially destroy the delicate bones (ossicles) of the middle ear, leading to hearing loss, dizziness, and facial muscle paralysis.
Symptoms
Hearing loss (often progressive)
Ear drainage (often foul-smelling)
Ear pressure or fullness
Tinnitus (ringing in the ear)
Dizziness (vertigo)
Facial weakness (in severe cases)
Ear pain (less common, but possible)
Causes
Eustachian tube dysfunction: This is the most common cause. The Eustachian tube connects the middle ear to the back of the throat. When it doesn't function properly (e.g., due to allergies, colds, or sinus infections), it can create negative pressure in the middle ear, causing the eardrum to retract and form a pocket or cyst.
Congenital: In rare cases, a cholesteatoma can be present at birth (congenital cholesteatoma).
Eardrum perforation: A hole in the eardrum can allow skin cells to enter the middle ear.
Medicine Used
Antibiotics: Used to treat any secondary infections associated with the cholesteatoma (ear discharge).
Ear drops: Antibiotic or antifungal ear drops may be prescribed to treat infection and reduce inflammation.
Pain relievers: Over-the-counter or prescription pain relievers can help manage ear pain.
Surgery: Surgery is the primary treatment to remove the cholesteatoma.
Is Communicable
No, cholesteatoma is not contagious or communicable. It cannot be spread from person to person.
Precautions
Prompt medical attention: Seek medical care if you experience ear pain, drainage, hearing loss, or dizziness.
Avoid water exposure: Keep the ear dry to prevent infection. Use earplugs when swimming or showering.
Follow treatment plan: Adhere to the prescribed medication regimen and follow-up appointments after treatment.
Eustachian tube function: Manage allergies and treat sinus infections promptly to prevent Eustachian tube dysfunction.
Regular ear exams: Children with a history of ear infections should have regular ear exams.
How long does an outbreak last?
Cholesteatoma is not an "outbreak" type of disease. It is a chronic condition that persists and grows if left untreated. Symptoms can fluctuate in severity, especially with secondary infections, but the cholesteatoma itself doesn't resolve without medical intervention (usually surgery).
How is it diagnosed?
Otoscopic examination: A doctor examines the ear canal and eardrum with an otoscope.
Hearing test (audiometry): Evaluates the extent and type of hearing loss.
Tympanometry: Measures the movement of the eardrum.
CT scan: Provides detailed images of the middle ear and mastoid bone to assess the size and extent of the cholesteatoma and any bone erosion.
MRI scan: can be useful in larger or complicated cases to differentiate cholesteatoma from other soft tissue masses.
Timeline of Symptoms
The timeline of symptoms varies but generally progresses as follows:
Early stages: Mild hearing loss, ear pressure, and intermittent ear drainage.
Progression: Increasing hearing loss, persistent foul-smelling ear drainage, tinnitus, and dizziness.
Advanced stages: Facial weakness or paralysis, severe pain, and potential complications like brain abscess or meningitis (rare).
Important Considerations
Early diagnosis and treatment are crucial: Untreated cholesteatoma can lead to serious complications, including permanent hearing loss, facial paralysis, and brain infections.
Surgery is often necessary: Surgical removal of the cholesteatoma is the most effective treatment.
Recurrence is possible: Even after surgery, there is a chance that the cholesteatoma can recur, so regular follow-up appointments are essential.
Hearing rehabilitation: After surgery, hearing aids or reconstructive surgery may be needed to improve hearing.
Long-term monitoring: Lifelong monitoring is important to detect any recurrence and manage potential complications.