Cholesteatoma

Cholesteatoma is an abnormal skin growth in the middle ear (air-filled central cavity of the ear) behind the ear drum. It is a skin cyst formed when the ear drum is pulled into the middle ear. 

When the Eustachian tube responsible for equalizing pressure in the middle ear does not work properly because of an allergy, a cold, or sinusitis, changes in air pressure create a partial vacuum in the ear, which sucks in the ear drum, creating a sack. This sack fills up with old skin cells, wastes and fluids, growing into a cyst. 

Although it resembles a tumour, a cholesteatoma is benign and not cancerous. However, if left untreated, the cyst can grow bigger and destroy the ear bones responsible for hearing, affecting a patient’s hearing, balance and functioning of other facial muscles. 

Cholesteatoma is primarily caused due to ear infections which weaken certain areas in the middle ear, making it more likely to develop a cyst there. In some cases, cholesteatoma may be present in a child at birth, though this form of congenital cholesteatoma is rare. ​​

If you believe you may be suffering from cholesteatoma, you may not be able to notice it since its symptoms are mild initially. However, as the cyst grows in size, the symptoms become more severe and noticeable, causing problems within your ear.

The symptoms of cholesteatoma start off with an unpleasant smelling pus or liquid being drained from the affected ear. As the cyst increases in size, you may feel more pressure inside the ear, leading to discomfort and pain behind the ear. The pressure from the cyst may also lead to hearing loss and loss of balance, which can make you feel dizzy as well. 

The symptoms of cholesteatoma vary according to the size of the cyst. In severe cases, it may also affect facial muscles, some of which may be paralyzed.​

The symptoms of cholesteatoma are few and should not be ignored. Any discharge from your ear should be a cause for concern, necessitating immediate consultation from the team of internationally accredited doctors at the Eye, Ear, Nose and Throat Service Line of The Aga Khan University Hospital.

Since cholesteatoma can lead to hearing loss and other serious problems, it is essential that you do not ignore the symptoms and seek a visit to your ENT (Eye-Nose-Throat) doctor at The Aga Khan University Hospital. In addition, if you have had a history of chronic ear infections and have been experiencing ear pains which have been gradually increasing in intensity, you must consult with your doctor.

You can discuss your symptoms and medical history in complete confidence with the highly qualified staff at the Eye and ENT Service Line of the Aga Khan University Hospital. With our commitment to quality healthcare, you can rest assured that your individual case will be handled with utmost care and personalized attention.

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.

An examination of your ear by the doctor will confirm the presence of cholesteatoma. A special instrument called the otoscope allows the doctor to examine the inside of your ears for any signs of a growing cyst. Usually, deposit of skin cells or large blood vessels can indicate the presence of a cyst inside the ear.  

For further investigation, your doctor may also request a CT (Computerized Tomography) scan to assess how much the cholesteatoma has spread in the ear. This is a painless imaging test which allows your doctor to see inside your brain. The CT scan will also help rule out any other causes of dizziness, if that’s one of the symptoms. The Clinical Imaging Service Line at The Aga Khan University Hospital provides the services of a CT scan for patients in a safe and secure environment, with reports and results dispatched in a timely manner​.

Since cholesteatoma can become serious if left unchecked, it requires prompt treatment. The first step in treating this disorder involves drying up the infection with the help of antibiotics, given both orally and as ear drops. In addition, the ear is also cleaned under the surgical microscope to clear up the infection. Once the infection has been cleared, the doctor will proceed to do a microsurgery to remove the cyst. 

In cases where the cholesteatoma has progressed further and grown a lot in size and the infection has become very severe, an immediate, major surgery may be required and you may have to stay in the hospital a longer time. If your ear bones have been damaged due to the cyst, you may need additional surgery to fix them.  

After the surgery, your ENT specialist at the Eye, Ear, Nose and Throat Service Line at The Aga Khan University Hospital will schedule a follow-up appointment to evaluate your condition and ensure that the cyst has not recurred. 

Timely intervention and prompt treatment of ear infections are important to prevent cholesteatomas from growing very large. Treatment and associated surgery is usually uncomplicated if the disease is detected and diagnosed earlier and the needed course of action is initiated at the right time. Therefore, it is important for you to book an appointment immediately with a doctor at the Eye, Ear, Nose and Throat Service Line of The Aga Khan University Hospital when any signs and symptoms of cholesteatoma are detected.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​



The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.