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What is cholesteatoma and how to cure it?

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What is a cholesteatoma?

Cholesteatoma is the name given to the skin cyst that forms inside the middle ear, within the ear canal, posing a risk to neighboring structures.

This growth of dead tissue, skin cells, and debris enlarges over time, compromising the areas of the ear canal and potentially leading to perforation of the eardrum, as well as damage to cranial bones, including the mastoid and temporal bones.

A cholesteatoma can grow to such an extent that it may erode the structures of the middle ear and the facial nerve, causing damage to hearing, balance, and even interfering with the function of facial muscles.

It can be a congenital condition present in a patient from birth; however, it is more commonly seen to develop as a result of prolonged ear infection that leads to an accumulation of epithelial cells from blood vessels and triggers an infectious process that ultimately damages the Eustachian tube’s function.

It’s essential to note that a significant portion of the mass formed consists of dead tissue and earwax debris, making the cholesteatoma highly susceptible to infection.

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Cholesteatoma symptoms.

Signs that may warn of this condition are:

  • Ear Pain: Ear pain is a common symptom, especially if the cholesteatoma causes an infection in the middle ear.
  • Ear Discharge: You may notice constant ear drainage, which can be foul-smelling due to debris accumulation.
  • Hearing Loss: Accumulation of tissue and debris in the middle ear can interfere with sound transmission, resulting in hearing loss.
  • Ringing in the Ear: Tinnitus, or ringing in the ear, is a possible symptom of cholesteatoma.
  • Feeling of Fullness: You may experience a sensation of fullness or pressure in the affected ear.
  • Dizziness: In some cases, cholesteatoma can affect balance and cause dizziness.
  • Headache: Headaches can be a symptom if the infection or pressure in the affected ear radiates to the head.
  • Fever: In some patients, an increase in body temperature can be perceived as a consequence of the infection.
  • Irritability and Difficulty Sleeping: Cholesteatoma symptoms, such as pain and hearing loss, can cause irritability and difficulty sleeping, especially in children.

It’s important to highlight that cholesteatoma symptoms can vary, and not all patients will experience all of these symptoms.

If you have any of these symptoms, it’s essential to seek medical attention and request an ear examination for an accurate diagnosis and appropriate treatment. Cholesteatoma can be a serious condition if not treated promptly, making early care vital.

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As mentioned at the beginning, the causes of cholesteatoma can be hereditary genetic characteristics or as a consequence of a deficiency in the functioning of the Eustachian tube that causes a vacuum in the middle ear that drags elements to create the cyst.

Remember that the Eustachian tube is the channel connecting the area of the nose and the ear, allowing air to flow and facilitating the natural waste disposal process of the organs. If its function is disrupted, waste will begin to accumulate.

Risk factors for cholesteatoma.

One characteristic that can increase the risk of cholesteatoma is living with a chronic ear infection. When the infection is prolonged over time, it can alter the condition of the middle ear by disrupting the function of the Eustachian tube.

Diagnostic process.

In addition to discussing the patient’s symptoms and medical history, some tests will also be necessary for the ENT physician to diagnose the condition.

Considering that the symptoms can be confused with various diseases of the middle ear, the physician may recommend physical and imaging tests to rule out, such as:

  • Ambulatory observation with otoscope: With this instrument, the ENT physician can analyze the condition of the sac and eardrum and determine the characteristics of these organs.
  • Vestibular nerve tests: To evaluate the patient’s balance condition, an electronystagmogram may be recommended, which is a test that analyzes the signals sent to the nerves that interpret movement and balance.

Each of the tests are necessary to determine the reason for the symptoms. It is important to rule out all middle ear conditions in order to establish the appropriate treatment.

Possible complications of cholesteatoma.

Cholesteatoma can be dangerous when not treated in time because it is a cyst that can damage several nearby nerves and cause complications such as:

  • Meningitis, infection of the membrane covering the brain.
  • Damage to facial nerves, causing facial paralysis.
  • Permanent damage to hearing.
  • Brain abscess, i.e., the development of an infection in the brain.


As it is a cutaneous mass of spontaneous appearance, there is only one treatment: a surgery to remove the cholesteatoma.

The surgical option is the only viable and effective treatment to avoid the complications and symptoms caused by cholesteatoma. It is a quick and safe procedure in most cases. However, the patient must maintain preventive revision sessions to clean the ear and prevent the recurrence of the cyst.

Colesteatoma (1)

Dr. Lech ENT doctor

Can help you remove cholesteatoma in Panama.

Testimonials from Dr. Lech
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Laura Ruiz Ruiz
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