What is a cholesteatoma?

A cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it’s most commonly caused by repeated middle ear infections.

A cholesteatoma often develops as a cyst, or sac, that sheds layers of old skin. As these dead skin cells accumulate, the growth can increase in size and destroy the delicate bones of the middle ear. This may affect hearing, balance, and the function of facial muscles.

How common are cholesteatomas?

Cholesteatomas are not common. They can show up at any age, and men are more likely to get them than women. Please discuss with your doctor for further information.


What are the symptoms of a cholesteatoma?

The common symptoms of cholesteatoma are:

  • A persistent or recurring watery, often smelly, discharge from the ear, which can come and go or may be continuous
  • A gradual loss of hearing in the affected ear

A cholesteatoma usually only affects one ear. Some people may experience slight discomfort in their ear.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes cholesteatomas?

A cholesteatoma usually occurs because of poor eustachian tube function in combination with infection in the middle ear. When the eustachian tube is not working correctly, pressure within the middle ear can pull part of the eardrum the wrong way, creating a sac or cyst that fills with old skin cells. If the cyst gets bigger, some of the middle ear bones may break down, affecting hearing. Rarely, a congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones.

Risk factors

What increases my risk for cholesteatomas?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is a cholesteatoma diagnosed?

To determine whether you have a cholesteatoma, your doctor will examine the inside of your ear using an otoscope. This medical device allows your doctor to see if there are signs of a growing cyst. Specifically, they will look for a visible deposit of skin cells or a large mass of blood vessels in the ear.

Your doctor may need to order a CT scan if there are no obvious signs of a cholesteatoma. A CT scan might also be ordered if you’re showing certain symptoms, such as dizziness and facial muscle weakness. A CT scan is a painless imaging test that captures images from a cross section of your body. The scan allows your doctor to see inside your ear and skull. This can help them better visualize the cyst or rule out other possible causes of your symptoms.

How is a cholesteatoma treated?

Generally speaking, the only way to treat a cholesteatoma is to have it surgically removed. The cyst must be removed to prevent the complications that can occur if it grows larger. Cholesteatomas don’t go away naturally. They usually continue to grow and cause additional problems.

Once a cholesteatoma has been diagnosed, a regimen of antibiotics, ear drops, and careful cleaning of the ear will most likely be prescribed to treat the infected cyst, reduce inflammation, and drain the ear. Your medical professional will then be able to better analyze the growth traits of the cyst and make a plan for surgical removal.

In most cases, the surgery is an outpatient procedure. This means that you don’t have to stay in the hospital after the procedure. A hospital stay is only necessary if the cyst is very large or if you have a serious infection. The surgery is done under general anesthesia. After the initial surgery to remove the cyst, follow-up surgery to reconstruct any damaged portions of the inner ear and make sure that the cyst has been completely removed is often necessary.

Once the cholesteatoma is removed, you’ll need to attend follow-up appointments to evaluate results and ensure the cyst hasn’t come back. If the cyst broke any bones in your ear, you’ll need a second surgery to repair them.

After surgery, some people experience temporary dizziness or taste abnormalities. These side effects almost always resolve themselves within a few days.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage cholesteatoma?

The following lifestyles and home remedies might help you cope with cholesteatoma:

  • You may need to stay in hospital overnight after the operation, and you should plan to take a week or so off work.
  • When you get home, you’ll need to keep the affected ear dry. You should be able to wash your hair after a week, provided you don’t get water inside the ear. To avoid this, you can plug the ear with Vaseline-coated cotton wool.
  • You may be advised to avoid flying, swimming and doing strenuous activities or sports for a few weeks after surgery. At your follow-up appointment, ask when it will be safe to return to your usual activities.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: August 26, 2018 | Last Modified: August 26, 2018

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