Conditions and diseases
Symptoms and causes
What is it?
An eardrum is tight, like a trampoline. For some people, a portion of the eardrum loses its surface tension and a dip forms (a retraction pocket). The dip is usually not very deep and has gradual sloping walls. Skin flakes are then able to collect in this dip (naturally ocurring skin flakes mix with sebum, thus forming the earwax that is then directed towards the entrance of the ear canal). If the pocket becomes too deep, or if the walls are too steep and/or the angle is too sharp, then the skin flakes remain at the bottom of the pocket. Just like a sail cloth in the garden that has standing water collecting on it, it gradually rots. This process can also ocur with the skin enzymes. They further thin the eardrum, making the pocket deeper and deeper. In the end, a eardrum becomes a sort of trunk that leads to the middle ear, and grows around the auditory bones.
The entire middle ear and the cavities behind (the mastoid) it can fill up. Such a cholesteatoma is never malignant, but because it applies constant pressure, it can damage the delicate structures, primarily the auditory bones, in the ear.
Many patients go for years without symptoms and do not even realise they have this condition. But then, suddenly, the cholestatoma begins to apply pressure and to give rise to problems such as severe ear infections. The cholesteatoma can also grow around structures towards the facial nerve (facial paralysis), towards the inner ear (deafness, balance disorders), or towards the brain (meningitis). This sounds horrible, but it is very, very rare!
Diagnosis and treatment
Read more here about the treatment of cholesteatomas.
Treatment centres and specialisations
Latest publication date: 02/04/2021
Supervising author: Dr Marin Eline