Cholesteatomas
Cholesteatomas is a disorder which assumes the nature of a tumor like growth in the middle ear of a human body. Cholesteatomas usually originate from the skin cells which are found on the outside of the human eardrum that have become folded into the middle ear because of an ear infection which causes a swelling in the ear drum.
Cholesteatomas usually occurs in two types namely, acquired and congenital. The acquired type of cholesteatomas can be due to a rapture or retraction of the ear drum. This type is common in adults and can be acquired due to the above reason. Congenital cholesteatomas on the other hand is usually less common but if it occurs it is usually a condition a child develops right from birth and it normally develops behind the eardrum. The main difference between acquired and congenital cholesteatomas is that the later usually occurs in the anterior parts of the ear drum, while the acquired type usually forms in the pars flaccida region of the ear drum which is located in the posterior-superior part of the ear drum (Haginomori, S., and et al. 2008).
Patients with cholesteatomas usually complain of hearing problems which is usually on one side of the affected ear, the patients also experience ear pains, dizziness, and recurrent ear discharge. Development of granulation tissue and drain of discharge which comes out from the marginal perforation of the ear drum and can identified on examination. There is also development of cholesteatoma cyst which manifests with peeling of layers of scaly skin’s horny layers of epithelium, which can also contain cholesterol crystals. At times the resulting debris is infected with the organism known as Pseudomonas aeruginosa (Haginomori, S., and et al. 2008).
If left untreated cholesteatoma can affect the small bones which are found in the middle ear and cause deafness, nerve deterioration, vertigo and body imbalance. A recurrent complain of ear infection or flooding during the swimming exercise should be investigated as a probably cholesteatoma case.
Cholesteatoma patients always manifest several abnormal ear tests. Some of the common diagnostic tests include; audiograms which shows a conductive hearing loss, tympanograms which shows perforation of the ear drum, VEMP test which is absent on the side of the cholesteatoma, MRI scan which reveals presence of soft tissue in the middle ear and CT scan which reveals eroded temporal bone which accompanies the soft tissue in the middle ear.
Surgery is usually the main treatment remedy for cholesteatoma. An attempt is usually done to excise the inflammatory mass from the inner ear. Canal wall up and canal wall down are the two main types of corrective surgeries for cholesteatoma and all of them are done to remove the “matrix” of swollen cells as well as to enable an ongoing monitoring for recurrence of the disorder. The result of surgery is to improve hearing to about 20db of sound after surgery for cholesteatoma (Stankovic, 2008).
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