Benign Ear Cyst (Cholesteatoma)

When cells clump together, they can form a cyst, a small sac that’s filled with air, fluid, or something else. Sometimes, skin cells inside your ear can do this and cause a lump called a cholesteatoma.

The lump typically starts deep in your ear near your eardrum and grows toward your middle and inner ear. Cholesteatomas aren’t cancerous. But if you don’t treat them, they can cause problems, including hearing loss.

Symptoms

Cholesteatomas typically cause symptoms in only one ear. The signs include:

  • Constant sound inside your ear (tinnitus)
  • Dizziness (or vertigo)
  • Ear infection
  • Earache
  • Feeling of “fullness” in one ear
  • Fluid that smells bad and leaks from your ears
  • Trouble hearing in one ear
  • Weakness in half your face

If you’ve had a cholesteatoma for a long time and haven’t treated it, it can grow into other areas of your ear, like the part you use for balance. More seriously, it can turn into an infection in your inner ear or even in your brain. This can cause pus-filled swelling in your brain or meningitis. Both are very rare.

Causes

A cholesteatoma can happen for several reasons:

  • You get an ear infection or injury. Sometimes after an operation on your ear, a cold, or an allergy, your Eustachian tube doesn’t work normally. A vacuum is created in your middle ear, which sucks in your ear drum, making a sac — the perfect place for skin cells to collect. Cholesteatomas caused by ear infections are the most common kind.
  • You have a problem with a Eustachian tube. If the tube that connects your ear and your nose doesn’t work the way it should, your eardrum can’t handle changes in pressure well. That can make it collapse and become a pocket. Skin cells build up in the pocket and form a cholesteatoma.
  • It forms when you do. In rare cases, cholesteatomas start when babies are still developing. Part of the lining of the ear gets trapped inside bone as it grows. These are usually found early in childhood.

Treatment

There’s no medicine that will make a cholesteatoma go away. They usually need to be removed with surgery. It typically takes 2 to 3 hours, and you won’t need to stay in a hospital.

You’ll be given medicine to make you sleep, and the removal will be done in one of two ways:

  • Mastoidectomy: Your mastoid is the bone behind your ear. Your surgeon opens this bone up to remove the cyst.
  • Tympanoplasty: This fixes damage to your eardrum (tympanic membrane). Your surgeon uses cartilage or muscle from another part of your ear to fill any holes in your eardrum.

Surgery often helps with some of your hearing loss, but not always.

Cholesteatomas can be aggressive. They can come back if they’re not removed completely, so it’s important to see your doctor for regular follow-up visits.

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