Cholesteatoma MRI

Cholesteatoma is an abnormal, noncancerous growth of skin cells in the middle ear behind the eardrum. It can develop as a cyst or pouch that sheds layers of old skin, which build up inside the ear. Over time, this can increase in size and cause damage to the bones of the middle ear, the inner ear, and the surrounding structures.

Causes:

• Eustachian Tube Dysfunction: Poor function of the eustachian tube can lead to chronic ear infections, which can contribute to the formation of a cholesteatoma.
• Ear Infections: Recurrent ear infections can lead to negative pressure in the middle ear, pulling a part of the eardrum inward to form a pouch that can accumulate dead skin cells.
• Congenital: Some people are born with a small remnant of skin trapped in the middle ear that can develop into a cholesteatoma.
• Trauma: Injury or surgery to the ear can also cause a cholesteatoma.

Symptoms:

• Persistent ear drainage (otorrhea), often with a foul odor
• Hearing loss in the affected ear
• Ear pain or discomfort
• A feeling of fullness or pressure in the ear
• Dizziness or balance problems (in advanced cases)
• Facial muscle weakness (if the cholesteatoma has damaged the facial nerve)

Diagnosis

Diagnosis typically involves:

• Medical History and Physical Examination: Reviewing symptoms and performing an ear examination with an otoscope.
• Audiometry: Hearing tests to assess the extent of hearing loss.
• Imaging Tests: CT scans or MRI to determine the size and extent of the cholesteatoma and to check for any bone erosion or other complications.

Treatment

The primary treatment for cholesteatoma is surgical removal. The type of surgery depends on the size and extent of the growth:

• Microsurgical Techniques: These are used to remove the cholesteatoma while trying to preserve hearing and other functions.
• Reconstruction: Post-removal, reconstructive surgery may be necessary, especially if the bones of the middle ear are damaged.