Cholesteatoma

A cholesteatoma is where the cells from the outer layer of the eardrum migrates inwards towards the middle ear – forming a sack filled with keratin. This later causes infection of the adjacent structures and can lead to several complications. It can be present from birth but most of the time it is due to dysfunction of the Eustachian tube. Clinically it presents with a foul smelling discharge that do not respond to optimum medical or a hearing loss. The treatment for it is surgery. Most of the time a CT scan is needed to assess the complications and look at the anatomy. The surgery is called a mastoidectomy and is mostly done with a microscope but if the disease is only located in the middle ear one can attempt key hole surgery with an endoscope.