Cholesteatoma: Definition, Symptoms, Causes And Treatment

Cholesteatoma is a pathology of the ear which is quite rare in the population. However, its treatment can be complicated and its symptoms serious if it is not addressed quickly.

Cholesteatoma is a destructive damage to part of the mucous membrane in the middle ear  that turns into epithelial tissue, thus producing dead cells that become infected very easily. In other words, it is a cyst-like structure due to the appearance of scamous epithelium where a mucous membrane should be found. It is nevertheless a mild disorder.

According to clinical studies, this pathology causes irreversible hearing loss, destruction of bone structures and serious complications due to its expansive nature. So, even though this is a disease that only presents itself exceptionally, detecting its symptoms quickly and effectively is absolutely essential. Here we’ll tell you everything you need to know about cholesteatoma.

About its distribution

Many disorders can cause ear pain and it is therefore necessary to know the groups at risk for this pathology. Here is a series of data about its worldwide distribution:

• In general terms,  this is a very rare condition. It affects the population between 3 and 70 years old, with an average of 41 years.
• Its prevalence, that is, the number of individuals who have this disease in any given population, is 3 in 100,000 for children and 9 in 100,000 for adults.
• Although this is not common,  after treatment 10-20% of cases tend to relapse.

As we can observe, we are faced with a framework which rarely presents itself but which is also difficult to eradicate. Faced with this disease, an early diagnosis is essential because the more time passes and the more the cystic mass grows, thus affecting the hearing capacity and the well-being of the patient.

What is a cholesteatoma and what are its causes?

As we said earlier, this pathology corresponds to the formation of a non-neoplastic lesion due to the presence of keratinized scamous epithelium in an abnormal region. This can be located in the epitympanus, mastoid and middle ear cavity. There are three types of cholesteatoma:

• Congenital:  there are embryonic remains of skin in the presence of a healthy eardrum.
• Primary acquired:  it develops from pockets of tympanic retraction which, according to studies, are characteristic depressions in part of the eardrum.
• Secondary acquisition:  it comes from a perforation of the eardrum due to an infectious process, generally during childhood. This lesion heals inadequately and promotes the appearance of the cyst form.

The acquired types are considered a variant of chronic otitis media; the primary learning is the most common among the general population. It should also be noted that the typology of cholesteatomas can be classified according to the affected location in the ear canal.

Symptoms

The United States National Library of Medicine indicates that the symptoms of cholesteatoma can be diverse. The most common are the following:

• Fear of heights.
• Purulent secretion, which can become chronic  with the appearance of infectious processes inside the ear. There is sometimes a feeling of pressure in the skull.
• Hearing loss  due to the decrease in sound transmission that is generated with the occupation of the ear canal by the cyst.
• Paralysis of the facial nerve  due to compression of nearby structures.
• Brain abscess or meningitis.

As we can see, we are facing a pathology that can cause serious symptoms. These are due to the enlargement of the cyst over time which leads to complications and may even end up breaking some of the inner ear bones or other hearing structures. However, it should be noted that some patients present with this disease asymptomatically.

Treatment of cholesteatoma

Treatment of cholesteatoma is complex because  removal of the entire cystic mass is difficult. It is for this reason that 10 to 20% of cases can relapse over time. Periodic checks are therefore required.

The definitive treatment is surgical: it is necessary to extract the mass of the tissue, and sometimes by removing the chain of small bones from the middle ear. It is also possible that the surgeon will need to replace adjacent bones damaged by cartilage or synthetic structures.

Cholesteatoma is atypical but dangerous

As we have seen in this article,  cholesteatoma is an unusual pathology which is distributed in an atypical  but uniform manner within the population. When faced with hearing loss or ear pain, this disease is one of the last that we have to consider.

Despite its strange nature, cholesteatoma can cause real damage to the patient’s hearing system if the patient does not act quickly. So, in the event of a hearing problem, it will always be best to consult a doctor.