Choesteotoma
What is a cholesteatoma and how does it affect the ear?
A cholesteatoma is a benign growth of skin that forms an abnormal sac inside the middle ear and mastoid bone. Although non-cancerous, it can be destructive, eroding the hearing bones (ossicles) and potentially damaging nearby structures like the facial nerve, inner ear, or skull base. Common symptoms include hearing loss and persistent ear drainage, especially if the sac becomes infected.
How is a cholesteatoma treated?
Treatment involves surgical removal through an outpatient procedure called tympanoplasty with mastoidectomy. Tympanoplasty involves repairing or reconstructing the eardrum, while mastoidectomy removes infected or diseased mastoid bone. If the ossicles are damaged, they may also be reconstructed during the procedure.
What is a “canal wall down” mastoidectomy and when is it needed?
In cases of large or recurrent cholesteatomas, a canal wall down mastoidectomy may be required. This technique connects the ear canal to the mastoid cavity, creating an open space that allows for easier monitoring and cleaning during follow-up visits. It helps reduce the risk of recurrence and ensures long-term ear health.
What are the goals of cholesteatoma surgery?
The main goal is to create a safe, dry ear by removing the disease. Preserving or restoring hearing is a secondary goal. In cases of extensive cholesteatoma, a second-look surgery is often scheduled 6 to 9 months later to confirm that no residual disease remains.
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