A cholesteatoma is an abnormal skin growth behind the ear drum in the middle ear – the word literally means a ‘growth made of wax’.

These are thought to develop over time where there has been repeated damage to the eardrum either by tearing or repeated infection and/or where the eustachian tube has not been able to allow fluid to drain properly from the inner ear. In that case a vacuum forms in the middle ear which in turn deforms the eardrum and creates the skin growth.

As the cholesteatoma gets larger it can put pressure on (and in some cases destroy) the delicate bones in the middle ear and ultimately affect other nearby bone and tissue.

Although in many cases a cholesteatoma will not cause any noticeable symptoms, there may be some hearing loss and a feeling of some pressure in the ear, particularly at night. There may also be a smelly discharge from the affected ear. As described above, these symptoms may also be accompanied by dizziness and weakness of facial muscles on the same side of the face.

Although a cholesteatoma is a type of abnormal growth, it is not cancerous and is classified as a benign tumour.

An examination of the ear by Dr Chang will determine if a cholesteatoma is present. Depending on the size and growth rate of the cholesteatoma, Dr Chang may treat initially with a clean of the ear and antibiotics and/or ear drops.

A large or complex cholesteatoma will almost certainly require surgery.

Most surgical procedures to remove a cholesteatoma are performed under general anaesthetic and generally take 2-3 hours, with the patient generally able to return home the same day or after an overnight stay. The surgery involves the removal of the growth and repair of the middle ear, and occasionally requires removal of part of the mastoid bone if this has been affected by the cholesteatoma.

If the small bones in the middle ear (the ossicles) have been damaged repair or reconstruction may be necessary (an ossiculoplasty). Ossicle repair may need to take place at a later date (generally 6-12 months later), when the ear is also examined to make sure that the cholesteatoma has been completely removed and has not regrown.

Full recovery from surgery generally takes one to two weeks.