| Risk Factors
A cholesteatoma is a type of cyst found in the middle ear behind the eardrum. It is a noncancerous tumor.
Regions of the Ear
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A cholesteatoma forms when the skin grows through the hole in the middle of the ear. It can occur due to a damaged eardrum or a defect at birth.
Factors that increase your chance of a cholesteatoma include:
- Chronic ear infections
- A poorly functioning eustachian tube
- Down syndrome
- Turner syndrome
- Cleft palate
- Abnormalities of the bones of the skull and face
- A family history of chronic middle ear disease or cholesteatoma
- Hearing loss
- Discharge from the ear, sometimes foul-smelling
- Pressure in the ear
- Numbness of the ear
- A sensation of spinning when you are not moving—vertigo
- Muscle weakness in the face on the affected side
You will be asked about your symptoms and medical history. A physical exam will be done. Diagnosis is usually made based on visual symptoms.
Images may be taken of your middle ear and surrounding structures. This can be done with:
Your nerve function may be tested. This can be done with:
- Hearing tests and balance tests
- Caloric stimulation
Cholesteatoma is a serious medical problem. Early treatment is vital for the best outcome. Serious complications may occur if the tumor goes untreated, including
hearing loss, muscle weakness, and vertigo. If the infection spreads to the brain it can lead to meningitis and brain abscess.
Cholesteatoma responds well to surgical treatment. Patients are likely to recover fully without complications if the tumor is caught and treated early with surgery.
Surgery prevents complications such as hearing loss and balance problems. Thorough cleaning of the ear is necessary to remove fluid and bacteria. It is done with a scalpel or a needle and a syringe. Eardrops are also usually given to prevent the infection from returning.
Medications are necessary to dry the fluid in the ear if allergies or other causes are producing excess fluid.
Cholesteatomas caused by defects at birth cannot be prevented. However, proper treatment and close follow-up of ear infections can help prevent cholesteatoma.
Cholesteatoma. EBSCO DynaMed Plus website. Available at:
http://www.dynamed.com/topics/dmp~AN~T115151/Cholesteatoma. Updated January 12, 2016. Accessed September 27, 2016.
Cholesteatoma. ENT Health Information: Ears. American Academy of Otolaryngology—Head and Neck Surgery website. Available at:
Updated March 2011. Accessed August 10, 2015.
Levenson M. Cholesteatoma. Ear Surgery Information Center website. Available at:
Accessed August 10, 2015.
4/29/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T115151/Cholesteatoma: Angtuaco EJ, Wippold FJ, et al. American College of Radiology (ACR) Appropriateness Criteria for hearing loss and/or vertigo. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/HearingLossVertigo.pdf. Updated 2013. Accessed September 11, 2014.
Last reviewed August 2015 by Michael Woods, MD
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