A cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it's most commonly caused by repeated middle ear infections.
A cholesteatoma often develops as a cyst, or sac, that sheds layers of old skin. As these dead skin cells accumulate, the growth can increase in size and destroy the delicate bones of the middle ear. This may affect hearing, balance, and the function of facial muscles.
What Causes a Cholesteatoma?
Besides repeated infections, a cholesteatoma may also be caused by a poorly functioning eustachian tube, which is the tube that leads from the back of the nose to the middle of the ear. The eustachian tube allows air to flow through the ear and equalize ear pressure. It may not work properly due to any of the following:
- chronic ear infections
- sinus infections
If your eustachian tube isn't working correctly, a partial vacuum might occur in your middle ear. This may cause a section of your eardrum to be pulled into the middle ear, creating a cyst that can turn into a cholesteatoma. The growth then becomes larger as it fills with old skin cells, fluids, and other waste materials.
What Are the Symptoms of a Cholesteatoma?
The symptoms associated with a cholesteatoma typically start out mild. They become more severe as the cyst grows larger and begin to cause problems within your ear.
Initially, the affected ear may drain a foul-smelling fluid. As the cyst grows, it will begin to create a sense of pressure in your ear, which may cause some discomfort. You might also feel an aching pain in or behind your ear. The pressure of the growing cyst may even cause hearing loss in the affected ear.
Call your doctor right away if you're having any of these symptoms. Vertigo, facial muscle paralysis, and permanent hearing loss can occur if the cyst continues to grow unchecked.
How Is a Cholesteatoma Diagnosed?
To determine whether you have a cholesteatoma, your doctor will examine the inside of your ear using an otoscope. This medical device allows your doctor to see if there are signs of a growing cyst. Specifically, they will look for a visible deposit of skin cells or a large mass of blood vessels in the ear.
Your doctor may need to order a CT scan if there are no obvious signs of a cholesteatoma. A CT scan might also be ordered if you're showing certain symptoms, such as dizziness and facial muscle weakness. A CT scan is a painless imaging test that captures images from a cross section of your body. The scan allows your doctor to see inside your ear and skull. This can help them better visualize the cyst or rule out other possible causes of your symptoms.