Richard Kang, M.D. Otolaryngologist
Cholesteatoma is essentially a skin that forms cysts in the wrong place. It is not a cancerous growth. It is just your skin, but it can be locally destructive because it can accumulate and infection can spread.
The Eustachian tube doesn’t work and it makes the children have more ear infections. The middle ear doesn’t get ventilated and that creates a vacuum that sucks the ear drum in, which is covered with skin. Other ways a cholesteatoma skin can get in is if you have a hole from having an infection, the skin can crawl in through the hole.
It looks like a pearl, so it has a pearly, shiny appearance, as opposed to more of a greyish looking ear drum.
It’s not something that occurs quickly. Usually, it’s based on somebody who has had it for a while and has had long term ear infections and they keep having smelly drainage even in spite of antibiotics and drops and then that will be the time for us to look.
There are the bones in the middle of the ears, and it can cause problems in those bones and it can cause problems with hearing. It can get into the inner ear, the cochlea, and that can lead to sensory nerve loss, and that can cause more permanent loss. It can get into and infect the facial nerve, so it can cause a droopy face. It can get into the inner ear that has the balance part, and it can make you dizzy so you can have dizziness and spinning sensations. If it gets deep enough and gets infected, it can also cause brain infections.
The infection will make it grow faster so we have to control the infection. Once it gets settled into the ear, we have to remove it and we have to do the surgically.
For every thousand or more kids or adults with ear infections, you get one that may have that. So fortunately it is not common, but it can be serious so it definitely needs to be evaluated by an ENT specialist.
A cholesteatoma is an abnormal skin growth in the middle ear behind the eardrum. D. Richard Kang, Board Certified Pediatric Otolaryngologist at the Boys Town Ear, Nose & Throat Institute and Co-Director of the Cochlear Implant Center, explains what causes a cholesteatoma, the symptoms and dangers it can cause, and how it is treated.