Treating Complex Ear Disease
Advanced evaluation and surgical expertise for cholesteatoma and its complications.
A Destructive Ear Condition
A cholesteatoma is an abnormal collection of skin cells, or keratinizing squamous epithelium, that develops in the middle ear or mastoid. Despite its name, it is not a tumor or cancer, but it can be destructive. If untreated, it can erode the middle ear bones and cause hearing loss, damage the facial nerve, or extend into the mastoid or inner ear, potentially causing serious complications such as meningitis or a brain abscess.
Where Cholesteatomas Come From
Cholesteatomas may be congenital, meaning they are present from birth, or acquired. Acquired cholesteatomas commonly form from a retraction pocket in the eardrum, often associated with chronic Eustachian tube dysfunction, where skin cells gradually accumulate. They can also result from a marginal eardrum perforation.
Symptoms to Watch for
Chronic or recurring ear drainage, often with a foul smell.
Progressive Hearing Loss
Ear Fullness or Pressure
Dizziness when the inner ear is involved.
Facial weakness when the facial nerve is involved, which is a serious sign.
Surgical Treatment for Cholesteatoma
Surgery is the only effective treatment for cholesteatoma. The goal is to completely remove the cholesteatoma while preserving or restoring hearing and protecting surrounding structures. Depending on the extent of the disease, surgery may involve a canal wall up or canal wall down mastoidectomy. A second look procedure may also be planned to check for residual or recurring disease.
Specialized Care for Complex Cases
Cholesteatoma surgery is technically demanding, especially in revision cases or when the disease has spread extensively. My fellowship training in neurotology provides specialized expertise in this area.