A cholesteatoma is where a sac of dead skin cells forms in a pocket in the middle ear. The cholesteatoma will slowly get bigger and eventually fill the middle ear and mastoid bone. The cholesteatoma can cause an unpleasant-smelling discharge and loss of hearing. (see figure 1)
What are the benefits of cholesteatoma surgery?
The aims of surgery are to remove the cholesteatoma and stop the discharge. It may be possible to improve your hearing at the same time.
Are there any alternatives to surgery?
Regular cleaning and antibiotics will help to keep any unpleasant-smelling discharge or infection under control.
What does the operation involve?
The operation is performed under a general anaesthetic and usually takes between two and two and a half hours.
Your surgeon will make a cut in front of or behind your ear. They will remove bone from around the cholesteatoma to see where it has spread to and remove it.
Your surgeon may need to remove the bone of your ear canal. If this happens, they will shape the bone behind your ear (mastoid bone) into a cavity that opens into your ear and make a graft for your eardrum.
What complications can happen?
1. General complications of any operation
Pain
Bleeding
Unsightly scarring
Blood clots
2. Specific complications of this operation
Hearing loss
Damage to the facial nerve
Change of taste
Dizziness
Tinnitus
Ear discharge
Allergic reaction
How soon will I recover?
You should be able to go home the following day. You should stay off work for about three weeks.
If your surgeon needed to shape your mastoid bone into a cavity, you will probably need to go to the outpatient clinic several times in the first few months until the cavity has healed completely. Most people are able to swim after surgery.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, you should ask a member of the healthcare team or your GP for advice. If the bone of your ear canal was not removed, some cholesteatoma may be left behind.
Summary
A cholesteatoma can damage your ear and cause serious complications. Surgery is the only way you can be cured.
Paying for your operation
Surgery for cholesteatoma costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.
Acknowledgements
Author: Miss Ruth Capper MD FRCS (ORL-HNS)
Illustrations: Hannah Ravenscroft RM
This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.
