A cholesteatoma is a ball of skin cells growing in the wrong place in the ear. It can cause oozing from the ear, hearing loss, and dizziness. A cholesteatoma nearly always needs to be treated with an operation to stop further problems. Unfortunately though, they can come back.

What causes cholesteatoma and who can get it?

Anyone can get a cholesteatoma. Very occasionally you can be born with one, but the most common reason that one occurs is due to problems with the Eustachian tube.

The Eustachian tube connects the back of the ear to the back of the nose and keeps the air pressure either side of your eardrum equal. If it doesn’t work properly this can cause the eardrum to be pulled inwards. A tiny pouch can form which can fill up with fluid and old skin cells. The pouch becomes bigger and grows inwards. This is the cholesteotoma.

If it isn’t treated the cholesteatoma can destroy the little bones in your ear that help you to hear. Very rarely they can even push onto your brain and cause infection there.

What are the signs and symptoms of cholesteatoma?

Symptoms of cholesteatoma include:

• Bad smelling fluid draining from your ear
• Hearing loss in the ear
• Dizziness.

How is it normally diagnosed and treated?

A doctor will often be able to tell if you have a cholesteatoma simply by looking in your ear. Sometimes your doctor may want you to have a CT scan (CAT scan), that takes a detailed picture of the inside of your ear. This will show how much the cholesteatoma has spread in the ear.

A cholesteatoma usually needs to be removed in an operation by an ear, nose and throat (ENT) specialist doctor (surgeon). He or she removes the pouch and will have to drill away some of the bone behind the ear to clear the cholesteotoma completely. This is called a mastoid exploration. 

The operation is usually successful, but a cholesteatoma can come back and another operation may be needed.

What’s going to help?

There isn’t really anything you can do to stop yourself getting a cholesteotoma. But you should see your doctor if you have bad smelling ooze from your ear for a while.

Looking forward

After an operation to remove a cholesteatoma you will have to keep your ear dry until you see your surgeon, which is usually in about two to three weeks time. There will be a dressing in your ear that will then be removed. You will not be able to swim for about six weeks afterwards, or until your surgeon says your ear has fully healed and it’s safe.

Most people make a full recovery after having a cholesteatoma. It’s not unusual to have some sort of hearing loss after the operation as the cholesteotoma often wraps around the little bones of hearing in the middle ear. This can be treated after your ear has healed.

For more help and information

If you would like to know more about cholesteatoma, please ask your doctor.

Last reviewed by Great Ormond Street Hospital: 29 August 2007

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