Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. It is an epidermoid cyst of the middle ear and/or mastoid. It usually develops as a consequence of eustachian tube dysfunction and chronic otitis media. If untreated, a cholesteatoma can eat into the three small bones located in the middle ear, causing nerve deafness, facial nerve paralysis, imbalance and vertigo. Although unusual, it can erode through the skull base into the brain, rarely causing life threatening infections.

Common symptoms of cholesteatoma may include hearing loss, foul discharge or bleeding from the ear, dizziness, vertigo, balance disruption, earache, headaches, tinnitus, or facial nerve weakness.

Surgery is usually required and consists of a tympanomastoidectomy. Many times more than one surgery is necessary. The goal of the first procedure is to remove the sac of squamous debris, clear out any infection, and repair the retracted or perforated eardrum. Secondary surgery is usually necessary to explore for a possible recurrence, and reconstruct the hearing if no cholesteatoma is present. Some people are a candidate for a single stage canal wall down mastoid surgery. This can be discussed with your physician.