Cholesteatoma

A cholesteatoma is a benign skin growth that can develop behind the eardrum in the form of a cyst. It can affect hearing, balance and facial muscles. Left untreated, these cysts can lead to complications, but solutions are available at ENT for Children. From the initial diagnosis to finding a treatment plan, our team is here to support your child.

What Causes a Cholesteatoma?

The Eustachian tube connects the middle ear and the throat. If this tube isn’t working properly, part of the eardrum can be pulled into the middle ear. This can create a cyst that fills up with fluids, skin cells and other materials.

In rare instances, children are born with cholesteatomas.

What Are the Symptoms of a Cholesteatoma?

• Dizziness
• Hearing loss in one ear
• Pressure or a feeling of fullness in the ear
• Drainage from the ear

What Complications Can Arise from a Cholesteatoma?

Without treatment, a cholesteatoma will continue to grow and has the potential for multiple complications, including:

• Damage to the eardrum, bones inside the ear and facial nerves
• Permanent hearing loss
• Chronic ear infections
• Meningitis
• Brain abscess

How Do Doctors Diagnose a Cholesteatoma?

Our provider will begin by examining your child’s ear. They’ll use an otoscope to look for clumps of dead skin cells or blood vessels, both of which are signs of a cyst. Additional tests may include a CT scan, which allows our ENT to view the inside of your child’s  ear and skull.

Throughout the process, our provider will take time to answer any questions your family may have and ensure you understand your child’s condition and how to treat it best.

What Treatment Options Are Available?

If our ENT has determined your child has a cholesteatoma, they’ll likely prescribe antibiotics to control the infection and reduce any inflammation. Because cholesteatomas don’t go away naturally and often continue to grow, surgery may be required.

Mastoidectomy

Larger cholesteatomas have often progressed to involve the tract of air cells behind the ear, known as the mastoid bone. If the cholesteatoma has grown into the mastoid, your child’s surgeon will have to access the bone to remove it completely.

The primary goal of a mastoidectomy is to achieve a “safe” ear by removing all of the cholesteatoma so that there is no further destruction or infection. Hearing restoration involving the ossicular chain reconstruction is often completed as a second surgery.

Ossicular Chain Reconstruction

If the three small bones behind the eardrum have been injured, an ossicular chain reconstruction surgical treatment is used. Known as the ossicular chain, these bones connect the eardrum to the inner ear. This surgery is used to reconstruct the ossicular chain and improve hearing. The surgery to reconstruct the ossicular chain is often completed during a “second-look” procedure. This “second-look” procedure is a follow-up surgery, usually 6-12 months later, to ensure that there is no residual cholesteatoma.

Ossicular chain reconstruction may be completed by making an incision behind the ear or going through the ear canal to make the incisions. If the middle ear bones are damaged, it may be possible to reposition them so that your child’s ossicles are used to complete the reconstruction. If the ossicles or parts of the ossicles are absent or damaged, then they are replaced with a manmade prosthesis that is often constructed from titanium. A prosthesis can be used to:

• Bridge a gap between damaged ossicles
• Bridge a gap from the ear drum to the residual ossicles (partial ossicular prosthesis)
• Bridge a gap from the ear drum directly to the inner ear (total ossicular prosthesis)

Our Team Is Here To Help

Being diagnosed with a cholesteatoma might feel stressful, but our team at ENT for Children can help. With treatment, your child can reconnect with the sounds of their world and engage with their favorite activities.