Cholesteatoma is a benign but potentially serious growth caused by the buildup of skin cells and protein behind the eardrum. This occurs when keratin-producing skin from the ear canal becomes trapped in the middle ear, often after an ear injury or repeated infections. If left untreated, the growth can erode hearing bones, damage the inner ear, and lead to permanent hearing loss or serious complications like facial paralysis or brain infections.

Diagnosis is typically made with microscopic examination of the ear. An audiogram helps assess hearing loss, while a CT scan may be used to determine how far the cholesteatoma has spread.

Treatment focuses first on controlling infection and preventing further bone damage. For small cholesteatomas with mild symptoms, in-office microscopic cleaning may be enough. In more advanced cases, surgery is required to remove the growth and repair damaged structures.

Surgical treatment may include:

• Mastoidectomy – removes infection from the mastoid bone

• Tympanoplasty – reconstructs the eardrum and hearing mechanisms

• Ossicular reconstruction – replaces damaged hearing bones with a prosthesis

Because cholesteatomas can return, close post-op monitoring is essential. Additional surgery may be needed in some cases to ensure complete removal.