At WaXtract we have seen a number of ears to clean that presented with recurrent discharge over many months and not settling down despite several course of antibiotics- oral and topical.
Our service is not a diagnostic one, but we are aware of abnormal and normal ears. If abnormal we sign post you to right channel to get appropriately diagnosed and on correct treatment pathway as early as possible if needed.
Cholesteatoma, a condition that affects the middle ear, is a complex and potentially serious medical issue. This blog aims to shed light on this often-misunderstood condition, exploring its causes, symptoms, diagnosis, and treatment. As I was a GP with Special interest in ENT for 27 years,, I understand the significance of raising awareness about cholesteatoma to promote early detection and effective management.
What is Cholesteatoma?
Cholesteatoma is an abnormal, noncancerous growth of skin cells that occurs in the middle ear, behind the eardrum. Unlike other skin cysts or growths, cholesteatoma is not typically the result of a congenital defect. Instead, it most often develops as a consequence of chronic ear infections, eustachian tube dysfunction, or as a complication of a perforated eardrum. Cholesteatoma can also arise from a history of repeated ear surgeries.
Symptoms
The most common symptoms associated with cholesteatoma include:
- Ear pain or discomfort
- Persistent foul-smelling discharge from the ear
- Hearing loss, which may worsen over time
- Tinnitus (ringing or buzzing in the ear)
- Dizziness or imbalance
Cholesteatoma can be asymptomatic in its early stages, so it can slowly progress without you even knowing there is anything wrong. Over time, untreated cholesteatoma can lead to severe complications, including hearing loss, facial nerve paralysis, and even intracranial complications such as meningitis or brain abscesses.
Diagnosis
Early diagnosis is crucial for the successful management of cholesteatoma. GPs play a vital role in recognizing potential cases and referring patients to specialists. To diagnose cholesteatoma, medical professionals often perform a thorough ear examination using an otoscope or operating microscope which we have at our WaXtract sites.. Imaging studies such as a computed tomography (CT) scan may be necessary to confirm the diagnosis and assess the extent of the condition.
Treatment
The primary treatment for cholesteatoma is surgical removal. Otolaryngologists, or ear, nose, and throat (ENT) specialists, typically perform this procedure. Surgery is necessary to prevent further complications and safeguard hearing. The choice of surgical technique depends on the size and extent of the cholesteatoma, and it may include tympanoplasty (eardrum repair) and mastoidectomy (the air cells in the hard bone behind your ear.). Following surgery, patients may require long-term follow-up to monitor their ear health and hearing.
Conclusion
Cholesteatoma is a condition that every GP should be aware of, given its potential to cause significant harm when left untreated. Early recognition and referral to specialists are paramount for the best outcomes. Furthermore, education on the importance of seeking medical attention for persistent ear symptoms and the management of long-standing ear infections is essential in preventing cholesteatoma.
So in conclusion, if you have a discharging ear that is not improving after treatment, seek help.
Waiting times are long these days, we can clean and ease symptoms, and give you the right language to use to steer through the challenging health system that exists these days.
Book a Microsuction ear wax removal appointment for peace of mind at our Lee-on-the-Solent or Winchester clinics here