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A cholesteatoma is cystic growth that occurs in the ear behind the eardrum. It is usually caused by Chronic Otitis Media infections and or Eustachian tube dysfunction that causes a retraction of the skin of the eardrum. Cholesteatomas often take the form of a pocket that sheds layers of old skin that builds up inside the ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear.



Initially, the ear may drain. As the cholesteatoma enlarges, it can cause a fullness and pressure in the ear, along with hearing loss and tinnitus. Facial muscle paralysis are rare but can result from continued cholesteatoma growth.

Ear cholesteatomas can be dangerous and should never be ignored. Bone erosion can cause the infection to spread into the surrounding areas, including the inner ear and brain. If untreated, deafness, brain abscess, meningitis, and rarely death can occur.

Initial treatment consists of a careful cleaning of the ear, antibiotics, and ear drops. Therapy aims to stop drainage in the ear by controlling the infection.

Large cholesteatomas usually require surgical treatment to protect the patient from complications. Hearing and balance tests, and CAT scans of the mastoid may be necessary. These tests are performed to determine the hearing level remaining in the ear and the extent of destruction caused by the cholesteatoma.

Surgery is performed under general anesthesia. The primary purpose of the surgery is to remove the cholesteatoma and infection, and achieve an infection-free, dry ear. Hearing preservation or restoration is the second goal of surgery. Surgery usually requires a mastoidectomy procedure.

Persisting earache, ear drainage, ear pressure, hearing loss, dizziness, or facial muscle weakness are signs of danger.



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