What is Cholesteatoma?
Cholesteatoma is an abnormal growth behind the eardrum in the middle ear. This condition can be congenital or usually occurs due to chronic ear infections. The most common symptom of the disease is a foul-smelling discharge from the ear.Cholesteatoma is referred to when dead skin cells accumulate behind the eardrum, forming a lump or cyst that can appear pearly.
In some cases, cholesteatoma is a congenital problem, but it usually occurs due to retraction of the eardrum or a perforated eardrum. If left untreated, cholesteatoma can lead to infections, hearing loss, or damage to the facial nerve.
Cholesteatoma Diagnosis Criteria
When diagnosing cholesteatoma, ENT specialists will first examine the patients for any signs of ear infection.
Then, various examinations will be conducted with an otoscope to inspect the eardrum. If cholesteatoma is suspected, some tests may be requested. These tests include:
- CT scan to see if the condition has damaged the ear bones
- Various hearing tests, including tympanometry
Causes of Cholesteatoma
One of the primary causes of cholesteatoma is the retraction of the eardrum. This occurs when there is an imbalance of air pressure between the inside and outside of the ear. When the eardrum retracts, the area behind it fills with skin cells, developing into a mass that becomes cholesteatoma.
Another cause of the disease is chronic ear infections or perforated eardrums. In rare cases, patients may be born with this condition.
Symptoms of Cholesteatoma
The symptoms caused by cholesteatoma vary depending on whether the condition is congenital or acquired. Congenital cholesteatoma is often referred to as congenital cholesterol and may not show any symptoms until children grow older.
Thus, congenital cholesteatoma is usually diagnosed during routine check-ups by pediatricians. Symptoms that may occur if the disease shows signs include:
- Pus discharge or foul-smelling drainage from the ear
- Pressure or fullness in the ear
- Dizziness
- Recurring ear infections
In some cases, the disease may also cause hearing loss or tinnitus.
Treatment Methods for Cholesteatoma
The only option for treating cholesteatoma is surgical procedures. Depending on the cause of the disease and the symptoms observed in patients, surgeries such as mastoidectomy or tympanoplasty may be performed.
Cholesteatoma Surgery
Cholesteatoma surgery can be performed using different techniques. One of these techniques is mastoidectomy. This surgical procedure is typically performed when the middle ear infection spreads to the skull and is also used to treat cholesteatoma. It is often done during cochlear implant surgery.
The extent of the surgery varies depending on the specific conditions of the patients. In simple mastoidectomy, the ear canal and middle ear structures are left intact while the disease in the mastoid is treated.
In canal wall mastoidectomy, more ear bone is removed to access the ear cavity. The ear canal is left intact in this procedure.
If the ear canal is irreparably damaged, the entire ear canal may need to be removed to eliminate the disease completely. This procedure combines the ear canal and mastoid bone into a large open area called the mastoid cavity, making it easier to access the cavity in the future.
Another method used in cholesteatoma treatment is tympanoplasty. This surgical procedure repairs and restores both the eardrum and the ossicular chain. It is suitable for patients with perforated eardrums or those who frequently struggle with middle ear infections due to the disease.
How long does cholesteatoma surgery take?
Cholesteatoma surgeries can take between one to three hours depending on the procedures performed. Surgeries under general anesthesia also need to account for the time required to administer and recover from anesthesia.
Life After Cholesteatoma Surgery
After cholesteatoma surgery, patients should pay attention to the following points:
- Patients should avoid actions such as coughing and sneezing that can strain the ear after surgery.
- Patients should refrain from physically strenuous activities for a few months following surgery.
- Water sports should be avoided for six months after surgery.
- Patients should avoid lifting heavy objects.
- Care should be taken to prevent water from entering the ear during showers.
- Avoid loud environments.
