Cholesteatoma
A growth that develops within the middle EAR. Most cholesteatomas develop as a consequence of frequent middle ear infections (OTITIS media) or chronically blocked eustachian tubes, such as by frequent SINUSITIS (sinus infection) or ALLERGIC RHINITIS. A cholesteatoma starts as an outpouching of SKIN on or near the TYMPANIC MEMBRANE (eardrum). SKIN cells accumulate inside the pouch, causing it to enlarge and exert pressure against the tympanic membrane and auditory ossicles (tiny bones of the middle ear). Over time the increased pressure can destroy the auditory ossicles, causing HEARING LOSS. A large cholesteatoma can also exert pressure inward against the inner ear, causing VERTIGO and balance disturbances.
Symptoms of cholesteatoma include the sensation of fullness in the affected ear, diminished hearing, dizziness and vertigo if there is pressure against the inner ear, and aching or dull PAIN behind the ear. Symptoms are often positional and may worsen at night, especially pain. Some people experience a puslike drainage, often apparent on the pillow. The diagnostic path may include Xrays, COMPUTED TOMOGRAPHY (CT) SCAN, and MAGNETIC RESONANCE IMAGING (MRI) of the head. Treatment requires overcoming any INFECTION with ANTIBIOTIC MEDICATIONS and sometimes surgery to remove the cholesteatoma and clean the area.
Treatment often restores hearing, though when the cholesteatoma is large or has been present for a long time the otolaryngologist may be unable to repair the damage to the middle ear. Damage that occurs within the inner ear often is permanent. Prompt treatment of sinusitis or otitis minimizes the risk for cholesteatomas to develop, though these growths are not preventable. Early diagnosis and treatment of cholesteatoma offers the best opportunity to prevent permanent hearing loss and vestibular (inner ear) dysfunction. Untreated cholesteatoma can result in profound hearing loss in the affected ear as well as MASTOIDITIS and MENINGITIS.
Symptoms of cholesteatoma include the sensation of fullness in the affected ear, diminished hearing, dizziness and vertigo if there is pressure against the inner ear, and aching or dull PAIN behind the ear. Symptoms are often positional and may worsen at night, especially pain. Some people experience a puslike drainage, often apparent on the pillow. The diagnostic path may include Xrays, COMPUTED TOMOGRAPHY (CT) SCAN, and MAGNETIC RESONANCE IMAGING (MRI) of the head. Treatment requires overcoming any INFECTION with ANTIBIOTIC MEDICATIONS and sometimes surgery to remove the cholesteatoma and clean the area.
Treatment often restores hearing, though when the cholesteatoma is large or has been present for a long time the otolaryngologist may be unable to repair the damage to the middle ear. Damage that occurs within the inner ear often is permanent. Prompt treatment of sinusitis or otitis minimizes the risk for cholesteatomas to develop, though these growths are not preventable. Early diagnosis and treatment of cholesteatoma offers the best opportunity to prevent permanent hearing loss and vestibular (inner ear) dysfunction. Untreated cholesteatoma can result in profound hearing loss in the affected ear as well as MASTOIDITIS and MENINGITIS.
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