Cholesteatoma is a condition characterized by the presence of epithelial cysts (composed of skin tissue and cells) in the middle ear and/or mastoid process, that arise as a result of chronic middle ear infections. Technically, these cysts are not tumors, but they grow independently.
Cholesteatoma cysts grow slowly, yet are able to erode and destroy bone in their path. Most commonly, this includes erosion of ossicles (the vibrating bones of hearing), but cholesteatoma can also erode:
- The inner ear, leading to nerve deafness and vertigo.
- The intracranial cavity, leading to infection around or inside the brain.
- The bone surrounding and protecting the facial nerve, leading to facial weakness or, in severe cases, paralysis.
Treatment
Cholesteatoma is treated with microsurgery. Several types of tympanomastoidectomy surgery exist for different degrees of cholesteatoma, and the appropriate surgery is selected based on the size and location of the cholesteatoma. Reconstruction of damaged ossicles is also possible but may require additional surgery depending on the findings of the initial surgery.
Cholesteatoma surgery may be lengthy due to the meticulous microdissection required. However, success rates for control of cholesteatoma are high and the risks of surgery are low.