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Cholesteatoma

A cholesteatoma is a build-up of skin cells in the middle ear or the bone behind the ear. It is not an ordinary plug of skin and is usually not cancer, but may keep growing, damage bone and cause serious infections.

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  • A cholesteatoma is a growing build-up of keratinising skin cells behind the eardrum or in the bone behind the ear.
  • It is usually not a malignant tumour, but may behave aggressively locally and damage bone, the hearing bones, balance organ, facial nerve and, rarely, structures around the brain.
  • Important symptoms are chronic or recurring smelly ear discharge and gradual hearing loss, often on one side.
  • An ear, nose and throat (ENT) specialist diagnoses it with ear examination and a hearing test; CT and sometimes MRI help establish the extent.
  • Cleaning and ear drops treat inflammation, but usually do not make a cholesteatoma disappear.
  • Surgery is often needed to remove it safely and achieve a dry, stable ear.
  • Long-term follow-up is essential because residual tissue or a new cholesteatoma may develop, even without clear symptoms.

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Further reading

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LipomaA lipoma is usually a benign, slowly growing lump of fat cells under the skin. It often feels soft, rubbery and movable and does not need removal if it causes no problems. A new lump still needs assessment; rapid growth, a deep or fixed position, pain, neurological loss of function or recurrence after removal does not necessarily fit an ordinary lipoma.
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Sudden hearing lossSudden hearing loss in one or both ears can result from earwax or middle ear problems, but also acute damage to the inner ear or hearing nerve. Unexplained sudden sensorineural hearing loss needs medical and ENT assessment the same day; early steroids may be appropriate.
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Glue earGlue ear means fluid behind the eardrum without an acute ear infection. It mainly occurs in children and can cause temporary hearing loss. It often clears on its own, but persistent hearing loss can affect language, learning and behaviour.