A cholesteatoma is a destructive and expanding sac in the middle ear and/or mastoid process. There are two types: congenital and acquired. Congenital cholesteatomas are the least common when it grows from birth behind the eardrum. Acquired cholesteatomas are the most common. Cholesteatomas in adults are usually caused be a tear or retraction of the eardrum secondary to a chronic ear infection.
A patient with a cholesteatoma may have a recurrent ear discharge. Granulation tissue and a discharge may be seen on examination by a physician. Other common symptoms of cholesteatoma may include: hearing loss, bleeding from the ear, balance disruption, ear pain, headache or tinnitus. If left untreated, a cholesteatoma can erode the three small bones located in the ear called the ossicles, which can result in nerve deterioration, permanent hearing loss, dizziness, and vertigo. A cholesteatoma has the potential to affect the facial nerve as well as erode the thin bone structure that isolates the top of the ear from the brain.
The treatment for a cholesteatoma is microscopic surgical removal. Since 10 to 20 percent of cholesteatomas may recur, follow-up checks can be required.