Adult Cholesteatoma: What you need to know

1. What is Cholesteatoma? Cholesteatoma can be referred to as a benign form of exfoliative otitis media. The disease is characterized by a keratinized mass, accumulation of dead cells (scabs) located in the middle ear or mastoid bone, which may be primary or secondary to perforation of the tympanic membrane. Cholesteatoma contains no cholesterol or fat, nor is it cancerous.
Primary cholesteatoma usually occurs due to an abnormality of the tube connecting the middle ear and nasopharynx. When subjected to prolonged negative pressure, the tympanic membrane is contracted in the middle and eventually forms a sac behind the eardrum that accumulates scaly dead skin cell debris and gradually forms a cholesteatoma. Hypoventilation due to keratinization delays recovery from infection, causes chronic infection, persistent exudates, and can eventually lead to tympanic retraction or tympanic membrane perforation. Secondary cholesteatoma occurs due to perforation of the tympanic membrane. Squamous epithelial cells accumulate from the damaged tympanic membrane into the inner middle ear forming a keratinized mass. Some cases of cholesteatoma form after tympanic surgery. Symptoms of the disease are quite variable, some people may be completely asymptomatic. Others may experience hearing loss, dizziness, and/or water in the ears. Cholesteatoma due to perforated eardrum is usually detected earlier and hearing loss or loss also occurs earlier. Usually, the doctor will probe to detect cholesteatoma in people with chronic purulent otitis media.
Please consult a doctor quickly for timely advice and treatment if you have abnormal ear problems, because if left untreated, the lesions can become severe or spread causing serious complications. important.

2. How will you go through the physical examination and diagnostic tests? Otoscopy can easily detect cholesteatoma in the case of a perforated eardrum. However, because of the masking of squamous epithelial cells, primary cholesteatoma is difficult to detect with conventional otoscope alone. An otolaryngologist may need to examine the ear with a microscope and aspirator to accurately diagnose your problem.
You may also need a computed tomography (CT) scan of the temporal bone to determine the extent of the disease, and the specialist will assess whether you have erosive bone lesions, or fistulas. Your doctor may order an MRI if you suspect brain damage or recurrence.
3. Common bacteria in ear infections Cholesteatoma Samples in your ear will be taken and cultured to identify pathogenic bacteria for accurate and effective treatment.
Bacteria isolated in cholesteatoma are diverse, but the most common are Staphylococcus aureus and Pseudomonas aeruginosa. Treatment failure with antibiotics often occurs when encountering blue pus bacilli.

4. Common Treatments You Can Go through 4.1. Medical treatment and drainage of fluid and pus in the ear Ear washing, drainage of pus, treatment of infections with antibiotic ear drops and oral antibiotics can be selected by your doctor depending on the severity of your disease.
Oral antibiotics are often considered if you are at risk for complications or severe infections, or you are at risk of developing resistant bacteria or have been treated with multiple courses of antibiotic ear drops empiric.
4.2. Surgery Surgical removal of the cholesteatoma and reconstruction of the tympanic membrane may be required. In the case of extensive damage, your doctor may consider mastectomy. Although the treatment of comorbidities such as allergies, chronic sinusitis, and tonsillitis may be beneficial, ultimately, there is no substitute for surgery.
Surgery will be considered and decided based on the extent of the disease, type and size of mastoid osteotomy, function of the middle ear and nasopharynx (Eustachian tube).
The doctor will examine and advise you before performing any procedure or surgery. You need to use prescription drugs, adhere to treatment and follow-up appointments on time to ensure effective treatment and avoid unwanted complications.

5. How to prevent cholesteatoma You can prevent chronic ear diseases such as chronic purulent otitis media or cholesteatoma by a few basic ways such as:
Always keep your ears dry, especially after bathing or showering. After swimming, keep your mouth, nose and throat clean. Avoid smoking and exposure to dusty environments. Be careful when removing earwax. You can visit an otolaryngologist for advice and support if you have difficulty with ear hygiene. Thorough treatment of upper respiratory tract diseases such as nasopharyngitis, tonsillitis, sinusitis, allergic rhinitis ... In addition, it is necessary to avoid self-administering antibiotics to reduce the risk of drug resistance. Adhere to treatment when antibiotics are prescribed to ensure complete cure and reduce the risk of developing resistance.
Hope the information in the above article helps you better understand Cholesteatoma in adults. If you have symptoms of the disease, you should soon go to specialized medical centers for examination and treatment.
Vinmec International General Hospital is a general hospital that has the function of examining and treating ENT diseases such as sinusitis, rhinitis, allergic rhinitis, chronic rhinitis, tonsillitis, and pain. throat, tinnitus and many other diseases. At Vinmec, we have also performed endoscopic diagnosis and treatment with modern medical methods for ear, nose and throat diseases, which not only brings high efficiency but also minimizes complications of recurrent disease. The great success is because Vinmec is always fully equipped with modern facilities, examination and treatment procedures are carried out by a team of experienced and qualified doctors that will bring about treatment results. optimal for customers.