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R. Sterling Hodgson, M.D.
1849 NW Kearney Street, Suite 200
Portland, OR 97209

Office: 503.553.3664
Fax: 503.553.3668




Cholesteatoma

Cholesteatomas were first described in early medical literature as "pearly tumors" in the middle ear but their name is actually something of a misnomer. These growths contain no cholesterol and are not a true "tumor", per se. Rather, they are more cyst-like in nature and most commonly arise in patients with a history of frequent ear infections sometime in the past, usually childhood. Symptoms then return, often years after the last infection. Most often gradual hearing loss, with or without persistent drainage from the affected ear, leads to the identification of a cholesteatoma. Detection can be difficult in some cases. Proper evaluation should include a careful history, examination of the ear, usually with a microscope, and a hearing test. A CT scan might be helpful in some cases if the diagnosis is not clear, or if complications from the cholesteatoma are suspected. The hearing loss is typically conductive in nature, meaning that sound is not transmitted properly through the eardrum and middle ear bones (ossicles). There might be some damage to the hearing nerve in selected cases.

The cholesteatoma is actually an ingrowth of skin that collects in small pockets in the middle ear, then may extend to the bone behind the ear know as the mastoid. The sloughed skin acts like a foreign body in the closed environment of the middle ear and becomes chronically infected, thereby creating the pearly growth that typifies cholesteatomas. These space-occupying growths can be congenital but are most often acquired over time. They affect children and adults alike and surgery is the preferred treatment. If left untreated, cholesteatomas can cause hearing loss and damage the delicate structures of the middle ear. In rare cases, dizziness and facial paralysis or weakness may occur. Surgery for this procedure is almost always done on an outpatient basis. The recovery period for both children and adults is relatively quick, usually within 5-10 days. The surgery requires thorough knowledge of the complex anatomy of the ear and regular experience performing this type of surgery to best avoid complications. In many cases the conductive hearing loss is amenable to reconstruction with modern techniques, leading to restoration of some or all of the hearing loss.

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R. Sterling Hodgson, MD | www.hodgsonmd.com | 503.553.3664
1849 NW Kearney St., Suite 200, Portland, OR 97209

 

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