![]() What are the risk factors for cholesteatoma?Ĭholesteatoma is more common in men than in women and is usually seen in people who have a history of ear infections. Sometimes a cholesteatoma in an adult can happen from having a grommet - a tiny tube that is put through the eardrum as a treatment for middle ear problems - as a child.Īround 7-13 people per 100,000 of the population will be diagnosed with a cholesteatoma each year, and it is estimated that an average GP will see around one new case every 4-5 years. Acquired cholesteatoma: develops later, usually in adults between 30 and 50 years old.This is a very rare condition and the cause isn't fully known. This becomes apparent between the ages of 6 months to 5 years when the child's hearing doesn't develop properly. This then causes long-term fluid in the middle ear (which is usually free of fluid) and can cause hearing loss. For some reason, even though the eardrum is normal, tiny skin cells get sucked into the middle ear, blocking the Eustachian tube. Congenital cholesteatoma: is a problem that in theory happens from birth.In the western world it would be very unusual for it to get that bad but this can happen in the developing world. If left untreated it will push further and further inside the ear causing permanent hearing loss, through the inner ear and possibly even next to the brain. It damages the delicate bones inside the middle ear - the bit that is responsible for hearing. ![]() This skin then forms a tiny pearl, or ball, that keeps burrowing its way deeper into the ear over many months. No one quite knows why this happens but it is usually related to the eardrum being very retracted (drawn inwards, deeper than it is meant to be). But with a cholesteatoma the skin right next to the eardrum, deep in the ear, gets sucked in gradually to where it shouldn't be. It is meant to be there and is a normal part of our ear. The cause of a cholesteatoma is quite difficult to explain, and even now is not fully understood. The movement of the fluid is sensed by tiny hairs in the semicircular canals which send messages to the brain down the ear nerve to help maintain balance and posture. The semicircular canals in the inner ear contain a fluid that moves around as we move into different positions. The cochlea converts the vibrations to sound signals which are sent down a facial nerve from the ear to the brain, allowing us to hear. The ossicles then transmit the vibrations to the cochlea in the inner ear. The sound vibrations pass from the eardrum to the ossicles. ![]() The sound waves cause the eardrum to vibrate. Sound waves come into the external ear and hit the eardrum. The inner ear includes the cochlea and semicircular canals. In the middle ear there are three tiny bones (ossicles) - the hammer (malleus), anvil (incus) and stirrup (stapes). Air comes from the back of the nose up a thin channel called the Eustachian tube. The middle ear, which is behind the eardrum (the tympanic membrane) is filled with air. The ear is divided into three parts - the external ear, the middle ear and the inner ear. Symptoms start very gradually, over several months. This is very unlikely to happen these days in the western world. Eventually, in very rare cases, it can spread right next to the brain and cause an infection in the brain tissue or the lining of the brain. Ringing in the ear (tinnitus) can also occur. A cholesteatoma is not painful.Īfter a while you may get hearing problems in that ear, if the cholesteatoma is left untreated it can spread into the balance centres of the inner ear, causing dizziness. ![]() The discharge might be slightly smelly and this often looks to a doctor like an external ear infection ( otitis externa) or an infection of the inner ear ( otitis media) with a perforated eardrum.īecause it looks just like these common infections, it is usually treated (wrongly) with antibiotic ear drops or pills and although it might get slightly better with these treatments, it will never fully clear up. It is usually slightly watery, sometimes with a green or yellow colour. The first symptom is usually a discharge from one ear. What are the symptoms of a cholesteatoma?Īn early cholesteatoma may have no symptoms. It is not a cancerous (malignant) condition but is important because it can lead to serious complications such as permanent deafness, damage to nearby nerves and life-threatening illnesses such as meningitis.
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