A cholesteatoma is a benign inflammatory formation of the middle ear. It is caused by the ingrowth of the skin layers (epithelia) inside the middle ear and inflammation. If left untreated, the tumour progress to neighbouring structures such as bones, causing irreparable damage. Specialists perform cholesteatoma surgery to preserve ear structures and hearing function.
Cholesteatoma is a benign ear tumour. It forms in the middle ear and is characterized by pain and hearing loss. The lump in its structure resembles a pearl, so it is also called a pearl tumour. The tumour varies in proportion so that it can be pea size or, lately, even a chicken egg size.
Skin cells line the outer ear canal in a healthy ear, while the middle ear is lined with mucosal cells. Between them is a thin tympanic membrane (eardrum). In the case of cholesteatoma, the eardrum is damaged, and skin tissue moves from the ear canal to the middle ear, causing ear infections, pain, and poor hearing.
In general, cholesteatoma is very rare. Approximately 10 out of 100,000 adults are diagnosed annually. The incidence in children is 3-15 cases per 100,000 kids each year.
What is the cause of cholesteatoma?
Cholesteatoma is caused by tympanic membrane damage that allows skin cells and bacteria to enter the middle ear.
Reasons for cholesteatoma growth are various, including:
- Infections, for example, otitis (inflammation of the ear) and tympanitis (inflammation of the eardrum);
- Trauma (a hole in the eardrum);
- Consequences of medical procedures.
Symptoms of ear cholesteatoma?
At first, the disease is relatively hidden. There are no signs in the early stage, after which the first symptoms resembling otitis media appear:
- Pain and pressure in the ear;
- Discharge of fluids or pus from the ear (otorrhea);
- Tinnitus (ear noises);
- Hearing loss;
- Loss of balance.
How is cholesteatoma diagnosed?
The ENT doctor performs a detailed examination, including ear otoscopy, hearing and balance tests, and neurological testing.
Ear otoscopy examines:
- Whether the eardrum is damaged;
- If there is inflammation;
- How far the cholesteatoma has advanced.
Sometimes the accumulation of ear wax and pus interfere with the examination, so the doctor cleans the ear before the procedure.
Otolaryngologists use balance tests to find out if the cochlea is affected. In addition, an audiogram evaluates the quality of hearing. Besides, imaging tests namely computed and magnetic resonance tomography, are helpful. CT or MRI of the ear shows the exact tumour location and size.
Cholesteatoma, unfortunately, cannot be cured only with medications. Therefore, drug therapy is carried out only as surgery preparation. Antibiotic ear drops destroy bacteria, reduce inflammation, and minimize complications during the operation. In addition, ear washing reduces symptoms.
The most effective and only way to treat cholesteatoma is ear surgery. The operation goal is to remove the cholesteatoma. At the final stage, physicians perform tympanoplasty (closing the eardrum hole). The operation results are correcting damaged bone tissue and hearing protection.
If hearing loss has occurred, it can be corrected with hearing aids. After surgery, doctors give some recommendations because sometimes cholesteatoma grows back.
The prognosis for ear cholesteatoma
The forecast after cholesteatoma surgery is favourable if it is done on time. In most cases, ENT doctors can remove the tumour without complications, and hearing improves significantly immediately after the operation.
However, the disease recurs in 10-20% of cases after treatment. In addition, pediatric cholesteatoma is more aggressive and is associated with a less favourable prognosis.
What is the best treatment for cholesteatoma?
The best treatment for cholesteatoma is ear surgery. First, doctors remove the tumour to avoid severe complications. Then, medications and antibiotics are given before surgery to control inflammation.
Is cholesteatoma surgery effective?
Yes. Operations for cholesteatoma are pretty effective since surgeons remove the tumour. After the operation, it takes time to heal, about two weeks. However, relapse occurs in 10-20% of cases.
How to select a good hospital for cholesteatoma treatment?
AiroMedical has already found the best clinics abroad for cholesteatoma treatment. When choosing a hospital, we consider several mandatory criteria: high experience and professionalism of doctors, modern equipment and the level of treatment success.
Can I treat cholesteatoma without surgery?
No. The cholesteatoma treatment is exclusively surgical. Doctors, during the operation, remove the tumour and correct the eardrum defects. Medications are used as a complementary therapy to relieve inflammation and pain.
Why do patients travel abroad for cholesteatoma treatment?
Specialized ear clinics have teams of qualified ENT doctors and surgeons to remove cholesteatoma. In addition, the latest types of hearing aids and new generations of drugs are available in hospitals abroad.
Where can I get Cholesteatoma treatment?
What are the best clinics for Cholesteatoma treatment?
Who are the best doctors for Cholesteatoma?
Prof. Dr. med. Barbara Wollenberg from University Hospital rechts der Isar Munich
Prof. Dr. med. Markus Suckfull from Academic Hospital Martha-Maria Munich
Prof. Dr. med. Markus Jungehulsing from MEOCLINIC Berlin
Dr. Arkadiusz Macha from KCM Clinic Wroclaw
Prof. Dr. Sami Katircioglu from Memorial Sisli Hospital Istanbul