Cholesteatoma
Cholesteatoma is a growth of skin cells behind the eardrum. As the cholesteatoma grows, it can cause damage to the ear drum and middle ear bones. Larger cholesteatomas may cause damage to the inner ear, facial nerve, the barrier between the brain and ear and even blood vessels in the brain.
It can take years before symptoms advance; the tissue can be destructive to normal structures, but it is not malignant. This condition can lead to chronic ear infections, dizziness and permanent hearing loss. Rarely, it can lead to facial muscle weakness or paralysis and serious infection of the brain, such as meningitis and brain abscesses.
Acquired cholesteatomas are the most common type of this condition, growing over time in a healthy ear, starting with a hole in the eardrum or forming when there is a history of longstanding eardrum retraction. The cause can also be infection, trauma or long-term difficulty in "popping" the ears during congestion or shifts in altitude.
Those with congenital cholesteatoma are born with the growth already behind an intact eardrum. Congenital cholesteatomas frequently go unnoticed for long periods of time. Symptoms may include hearing loss, pain, intermittent or continuous drainage from the ear, build-up of dry crusts in the ear and acute and chronic ear infections.Similar to acquired cholesteatomas, individuals with congenital cholesteatomas may also experience facial weakness, dizziness, paralysis, deafness and neurological symptoms.
Treatment requires outpatient surgery – typically a canal wall up tympanomastoidectomy is performed. In this surgery, Dr. Benson will work through both the ear canal and the mastoid to remove the growth from the ear. A second-look surgery is typically done six months to one year after the first tympanomastoidectomy to ensure no skin cells have regrown and, if necessary, repair damaged middle ear bones and/or replace them with titanium prosthetics. Occasionally a canal wall down surgery will be done to remove the cholesteatoma. In this circumstance, the ear canal and mastoid are joined into one cavity. The cavity will require visits with Dr. Benson for routine cleaning and surveillance. Determination of the type of treatment is based on the size of the cholesteatoma, the size of the mastoid bone and other anatomic issues of the ear.
