Cholesteatoma – Symptoms, Risks and Treatment
Typical symptoms include persistent ear discharge, unpleasant odour, progressive hearing loss, ear blockage, tinnitus, and episodes of dizziness. Some patients experience minimal symptoms initially, allowing the disease to advance silently. Chronic ear discharge that does not respond to treatment should always be evaluated by an ENT specialist.
If untreated, cholesteatoma may lead to extracranial complications such as erosion of the hearing bones, inner ear damage causing vertigo or sensorineural hearing loss, facial nerve weakness, mastoid infection, or post-auricular abscess formation.
In advanced cases, intracranial complications may occur, including meningitis, extradural abscess, brain abscess involving the temporal lobe or cerebellum, sigmoid sinus thrombosis, and otitic hydrocephalus. These conditions may present with severe headache, fever, neurological symptoms, vomiting, or altered consciousness and require urgent medical care.
When Should You Suspect Cholesteatoma?
Cholesteatoma should be suspected in patients with long-standing ear discharge, progressive hearing loss, recurrent infections, or persistent ear blockage despite treatment. Individuals with previous ear surgery, chronic sinus disease, or Eustachian tube dysfunction may be at increased risk. Early specialist assessment significantly reduces the likelihood of complications.
Cholesteatoma Surgery
Surgical removal is the definitive treatment for cholesteatoma. The procedure is performed using microscopic or endoscopic techniques to completely eradicate diseased tissue from the middle ear and mastoid. The primary goal is to create a safe, dry ear and prevent further complications. Whenever possible, hearing reconstruction is performed during the same operation or as a staged procedure. Recovery is usually straightforward, but long-term follow-up is essential as residual or recurrent disease may occur.
