Cholesteatoma is a collection of skin cells that grow abnormally in the middle ear, behind the eardrum to be exact. This condition can cause various disturbances to the hearing system, balance, and function of the facial muscles.
Cholesteatoma is not cancer and is a rare condition. The abnormal growth of skin cells in a cholesteatoma can occur due to recurrent middle ear infections ( otitis media ) or congenital abnormalities.
Although not cancer, cholesteatomas can progress to the point where they damage the bony structures in the middle ear. As a result, people with cholesteatoma can experience hearing loss and other serious complications.
Causes of Cholesteatoma
As previously mentioned, the main cause of cholesteatoma is recurrent middle ear infections. This condition can also be caused by a disturbance in the eustachian tube, which is the tube that connects the back of the nose to the middle ear.
The eustachian tube functions to balance the pressure inside and outside the ear. However, there are several conditions that can cause interference with the function of the eustachian tube, namely:
- Ear infections that last a long time (chronic)
- Cough and cold
- Allergic rhinitis
When there is interference with the eustachian tube, pressure will appear which causes some of the eardrum and some of the skin of the middle ear to be pulled inward. The skin then forms a cyst filled with ear fluid and dead skin cells which can get bigger over time.
Cholesteatoma can also be caused by damage to the eardrum that occurs as a result of injury, infection, or a side effect of ear surgery.
Although rare, cholesteatoma can result from congenital abnormalities. In this case, the cholesteatoma developed without any previous ear infection.
Generally, cholesteatomas only occur on one side of the ear. In its early stages, this condition may not cause symptoms. New complaints will appear when the cholesteatoma gets bigger. Some of these symptoms include:
- Ringing ears ( tinnitus )
- Dizziness or vertigo
- Pain behind the ear
- Discharge and discharge that smells bad from the ear
- Discomfort or fullness in the ear
- Hearing loss in the affected ear
- Changes in the taste and smell of cooking
When to see a doctor
Immediately check with your doctor if you experience the symptoms of cholesteatoma as mentioned above, especially if it is accompanied by vertigo or paralysis on one side of the face. Handling a cholesteatoma that is given early can help you avoid complications due to this condition.
To diagnose cholesteatoma, the doctor will first ask the patient about the symptoms they are experiencing and their medical history. The doctor will also do an ENT examination .
If needed, the doctor will scan the patient's head with a CT scan or MRI of the head, to see if the cholesteatoma has damaged the middle ear bones.
Cholesteatoma is generally treated by surgical removal of the cyst. The operation is performed by first giving the patient general anesthesia.
There are two types of surgery that doctors can perform, namely:
- Mastoidectomy, to open the bone in the ear so that the cyst can be removed completely
- Tympanoplasty, to repair damage to the eardrum
Meanwhile, to deal with ear infections that occur repeatedly, the doctor will perform the following treatments:
- Giving ear drops or oral antibiotics
- Ear canal cleaning
Cholesteatoma is a condition that often recurs. Therefore, doctors will advise patients to undergo regular ENT examinations every 6–12 months. Patients will also be advised to undergo a CT scan or MRI every 1–2 years after surgery.
If left untreated, a cholesteatoma that continues to grow in size will cause various complications. The accumulation of dead skin cells makes it easier for bacteria to develop, which can lead to ear infections.
Over time, a cholesteatoma can also damage the middle ear canal, eardrum, middle ear bones, brain, and facial nerve. As a result, complications arise in the form of:
- Hearing impairment
- Paralysis of facial muscles
- Brain abscess
There are no special precautions that can be taken if the cholesteatoma is caused by a congenital anomaly . However, children with cholesteatoma are advised to undergo regular ENT examinations to prevent worsening of the disease.
If the cholesteatoma is caused by recurrent ear infections, early to late treatment can prevent this disease from occurring.