A specialist explains: cholesteatoma essentials

Written in association with: Professor Mahmood Bhutta
Published:
Edited by: Sarah Sherlock

Though one of the smallest parts of the body, the eardrum and bones in the ear are important for our hearing ability. There are a multitude of conditions that can impact this ability, one being a cholesteatoma. In this article, expert consultant ENT surgeon Professor Mahmood Bhutta clarifies what it is and why it is important to have it taken care of.

 

cholesteatoma

 

What is a cholesteatoma?

A cholesteatoma is an abnormal growth arising from the skin of the eardrum. It grows inwards and will slowly destroy the bone of the skull around the ear. Once it starts it doesn’t stop, and it can damage the bones of hearing, the balance organs, or even spread to cause potentially life-threatening infection in the brain.

 

 

How does a cholesteatoma form?

Nobody really knows. They affect about 1 in every 10,000 people every year and mostly arise in people who have had problems with ear infection or inflammation earlier in life. We think that persistent inflammation causes the biology of the eardrum to go wrong, and so the skin starts growing inwards rather than outwards like normal.

 

 

What do they feel like?

Often, they cause mild symptoms in the early stages. There may be a bit of discharge from the ear from time to time, some mild pain, and eventually there will be some hearing loss. An ear that has these sorts of persistent symptoms really needs to be examined.

 

 

How is a cholesteatoma diagnosed?

The diagnosis is made by an expert looking in the ear in the clinic. If we see skin growing inwards from the ear drum, it’s a cholesteatoma. Sometimes it can be difficult to see what’s going on, and so occasionally people need to have the ear examined under an anaesthetic where we can get a better look.

 

 

How is cholesteatoma treated?

There is really only one treatment, and that is surgery. The cholesteatoma is removed and the ear drum is reconstructed and strengthened to try and stop the problem recurring. Often it is possible to also reconstruct the hearing, using artificial hearing bones. It is complex and delicate microscopic surgery that typically takes three to four hours.

 

 

If you are concerned about your hearing or would like more information, you can book a consultation on Professor Bhutta's profile.

By Professor Mahmood Bhutta
Otolaryngology / ENT

Professor Mahmood Bhutta is a consultant ENT surgeon with over 20 years of experience, based at The Montefiore Hospital, Hove and BMI Goring Hall Hospital, Worthing.

He is an expert in treating conditions all conditions of the ear and hearing, including ear discharge, ear pain, glue ear, holes in the eardrum, cholesteatoma, dizziness, hearing loss and earwax build-up. During training he undertook a PhD at the University of Oxford into the cause of chronic middle ear disease as the Phizackerley Scholar, was awarded the Margaret Witt Scholarship for Clinical Excellence by the Royal College of Surgeons of England and the TWJ Fellowship as the leading trainee in the UK in ear disease.

Professor Bhutta is a consultant to the World Health Organisation on the prevention of deafness and hearing loss. Through his global ear disease work he has trained health professionals in Cambodia, Zambia, Nepal, Fiji, Uganda, and South Africa. His research also includes environmental and labour rights harms in the manufacture and use of medical products.

Professor Bhutta is the inaugural Chair in ENT Surgery at Brighton and Sussex Medical School, a position awarded to him in recognition of his contributions to research in his field. He has written for numerous peer-reviewed journals and is a regular invited speaker at national and international conferences. He is on the board of the British Society of Otology, and his NHS practice is at University Hospitals Sussex.

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