Cholesteatoma is the name given to a collection of skin cells deep in the ear that form a pearly-white greasy-looking lump deep in the ear, right up in the top of the eardrum (the tympanic membrane).
Osteomas are pearl-like bony growths in the external ear canal. These can be small or large, and have a variety of shapes. The larger growths tend to be problematic because they interfere with the natural aeration and drainage of the external ear, at times trapping water or debris in the canal.
A cholesteatoma can develop if part of the eardrum collapses. Dead skin cells are normally passed out of the ear, but if the eardrum collapses, it may create a pocket where the dead skin cells can collect.
Cholesteatomas are lesions that most often arise within pneumatized portions of the temporal bone to include the middle ear and mastoid, or both, and are only rarely found within the external auditory canal. They are non-neoplastic, often destructive, locally invasive masses that present mainly as unilateral lesions.
The treatment is done by an ear, nose, and throat specialist (an ENT doctor) and usually consists of an operation under a general anaesthetic. The aim of the surgery is removing the cholesteatoma and then to clear out part of the middle ear so air can circulate around better.
Although surgery is rarely urgent, once a cholesteatoma is found, surgical treatment is the only choice. Surgery usually involves a mastoidectomy to remove the disease from the bone, and tympanoplasty to repair the eardrum.
Cholesteatomas are not cancerous, but if they're not treated, they can continue growing, get infected and eventually damage tiny bones in the middle ear. They can also cause loss of balance and loss of hearing in one ear.
Cholesteatoma treatment almost always needs surgery but to treat the concurrent infection, it may include: Antibiotics to get rid of infections. Ear drops to slow ear drainage.
Without treatment, a severe cholesteatoma can be fatal.
A cholesteatoma is detected only by examining the ear and finding the disease. However, the physician may suspect the disease when some or all of the following are present: Gradual loss of hearing.
In extreme cases a cholesteatoma can start to affect the brain. It can cause pus to pool in the brain (called an abscess) or an infection of the membranes covering the brain and spinal cord (called meningitis).
Cholesteatoma Surgery: What to Expect
A small incision will be made in the eardrum, and the cholesteatoma will be removed. The incision will then be closed with stitches. You may experience some pain and swelling in the ear after surgery. This is normal and can be treated with pain medication.
Basal cell carcinoma (BCC)
BCCs often look like a flesh-colored round growth, pearl-like bump, or a pinkish patch of skin. BCCs usually develop after years of frequent sun exposure or indoor tanning.
In fact, pearls are more like cancerous growths. A bit of the mantle tissue—the cells that form the inner layer of oyster's shell (aka mother of pearl, aka nacre)—just gets out of place, “and it just…
The cells can get trapped behind the eardrum and cause cyst-like pockets to evolve and accumulate. If not treated, these pockets can be dangerous and even erode the hearing bones, the inner ear balance system and spread into the mastoid bone.
Cholesteatoma can be a birth defect (congenital). It more commonly occurs as a result of chronic ear infection. The eustachian tube helps equalize pressure in the middle ear. When it is not working well, negative pressure can build up and pull part of the eardrum (tympanic membrane) inward.
Conclusions: The medially-invasive cholesteatoma demonstrates an aggressive, endophytic growth pattern, invading into the otic capsule or through the perilabyrinthine air cells to the petrous apex.
Most cases of cholesteatoma were found between the ages of 8 and 18 years old (eFigure 1 in the Supplement). In addition to the cases, 21 235 matched controls were included. The mortality in cases and controls were similar; 1472 cases (13.9%) and 2791 controls (13.1%) died during the study period.
Cholesteatoma is a problem involving skin of the eardrum or ear canal growing into middle ear and its surrounding areas. Its name is misleading as it is not a tumor however, if left untreated, it can become invasive and destructive.
A cholesteatoma or chronic ear infection may be present for many years without difficulty, except for the annoying drainage and hearing loss. However, the disease may expand and cause damage to surrounding structures. Dizziness, weakness of the face, and pain may develop.
The cholesteatoma growth is slow, but over time skin can erode bone and damage nerves. Cholesteatomas can also become chronically infected, leading to infections and foul-smelling drainage.
Stage I, single quadrant: no ossicular involvement or mastoid extension. Stage II, multiple quadrants: no ossicular involvement or mastoid extension. Stage III, ossicular involvement: includes erosion of ossicles and surgical removal for eradication of disease; no mastoid extension.