Cholesteatoma is a mass of keratinized squamous tissue growth that develops mostly in the middle ear and sometimes in the mastoid process, i.e. the region of the temporal bone located behind the ear.

This irregular protuberance is initially found as a lump of dead skin cells in the middle ear, but can gradually grow in size, with more cells accumulating. When this happens, it invariably leads to severe problems with hearing abilities, the sense of balance in the body, as well as damage to the facial muscles. Although cholesteatoma sometimes tends to cause grave consequences, it is non-cancerous in nature.

Moreover, a cholesteatoma can grow into a massive cyst or sac-like structure, resulting in injury to the soft, delicate ear bones.

In the majority of cases, cholesteatoma is acquired by children, teenagers or adults, due to frequent infections within the ear canals and structures. However, in some rare instances, an individual may also be born with the condition, termed as congenital cholesteatoma. Also Read: Ear Infections In Kids Are Common, Learn About Prevention

Since cholesteatoma could lead to irreversible destruction of ear muscles and bones if left unattended, it is absolutely essential to seek immediate medical care, as soon as any signs of infections in the hearing organs are observed in the person.


The most common reason for cholesteatoma is ear infections, wherein a vacuum is created in the middle ear, drawing in the eardrum and aiding in microbial germs to grow.

In certain cases, the Eustachian tube, which connects the rear end of the nose to the middle ear, does not operate normally, creating issues with handling pressure changes and forming a collapsed hole. This, in turn, allows skin tissue to accrue, leading to cholesteatoma.

Very rarely, the ear bones and muscles do not form and align properly as babies grow, giving rise to cholesteatoma right from birth.


The characteristic indications of cholesteatoma comprise:

  • Cysts in either one or both ears and ear infections
  • Unbearable pain in the middle ear and eardrum as in the case of otomycosis
  • Discharge of unpleasant smelling fluids from the ears
  • Difficulty hearing properly in the affected ear as in the case of a ruptured eardrum
  • Feeling fatigued, dizzy i.e vertigo
  • Sensation of feeling full and heavy in the ears
  • Weakness in facial muscles
  • Persistent ringing in the inner ear, known as tinnitus Also Read: Tinnitus Is Annoying, Learn How To Manage It

Diagnosis And Treatment

The doctor determines an instance of cholesteatoma using an otoscope, which is an instrument holding a magnifying lens and a light, to probe the structures of the middle and inner ear. External hearing tests are conducted, to gauge the ability of the ears to recognise sounds, voices and noises of differing decibels and intensities.

The healthcare provider also examines the tissues of the ears with more in-depth scans, such as MRI (Magnetic Resonance Imaging) and CT (computerized tomography). These advanced techniques help to visualise the blood vessels, bones and soft tissues in the ear clearly, to analyse the extent of damage to the structures of the ear.

Once the diagnosis of cholesteatoma is confirmed, the medical expert initiates the pertinent treatment. The only effective solution for this infectious ear ailment is surgery.

The two types of procedures to remove cysts and benign growths in a cholesteatoma are mastoidectomy and tympanoplasty.

In a mastoidectomy, the doctor operates on the mastoid bone situated behind the ear, to excise the abnormal tissue growths completely.

Tympanoplasty involves fixing the leaks in the eardrum by means of attaching neighbouring muscles, thereby restoring the normal structure and function of the eardrum, also called the tympanic membrane.

In this manner, pain, hearing difficulties and infections in the ear are cleared completely, ensuring optimal recovery of the affected person.

Cholesteatoma growths can recur and thus, it is vital to follow up with the ENT specialist even after successful surgery, to prevent any further middle ear infections from hampering hearing and body balance.