Diseases of the Ear - Cholesteatoma
Disease/Disorder Name:
Cholesteatoma
ICD-9 Description:
Cholesteatoma of Middle ear and Mastoid
Description:
Non-neoplastic
keratinizing mass with stratified squamous
epithelium, frequently occurring in the meninges,
central nervous system, bones of the skull, and most
commonly in the middle ear and mastoid region.
Cholesteatoma
A cholesteatoma occurs if skin from the
inner side of the tympanic membrane
sloughs off and mixes with ear wax that
penetrates the open hole in the eardrum
to the middle ear chamber and fails to
drain through the Eustachian tube. Over
time the accumulation of dead skin and
wax causes a cyst-like mass to grow. This is known as a
cholesteatoma. If left untreated and the
mass becomes larger, the mass can put
pressure to nearby parts of
the ear causing serious damage such as the eardrum and ossicles.
In serious cases, cholesteatomas have
been known to penetrate into the mastoid
area causing infection or into the
cranial chamber (brain) causing meningitis
(infection of the covering of the brain
- menges).
Cholesteatoma
- Symptoms
The attico-antral form of the condition
initially causes a smelly discharge to leak from the ear. You may also have a hearing loss and sometimes tinnitus. You can get vertigo - dizziness - if
the semicircular canals, which form part of the balance system, are
also affected.
Signs that damage is taking place include
- extreme pain, especially in the
side of the head where the problem is
- continual vertigo and nausea
- loss of hearing
- a gradual weakening of the facial muscles
causing a droopy look on one side as
if recovering from a stroke
- headaches similar to migraines
Treatment
for a
Cholesteatoma
It is important to remove the cholesteatoma and all traces of infection. For this, it is usually necessary to have a
surgical procedure known as
mastoid surgery.
If your ENT (Ear nose and throat
specialist) is not a surgeon, he/she may
refer you to an otolaryngologist (head
and neck surgeon) or the surgery.
The surgeon gains entrance to the middle
ear chamber by making an incision behind
the ear and through the mastoid bony
tissue. Once the middle ear chamber is
opened, the mass is removed and the
surgeon will check to make sure the
ossicles are not damaged and that the cholesteatoma
has not penetrated to other areas of the
cranium.
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