Cholesteatoma is a problem involving skin of the eardrum or ear canal growing into middle ear and its surrounding areas. Its name is misleading as it is not a tumor however, if left untreated, it can become invasive and destructive. In cholesteatoma, the skin cells become trapped in a pocket and can cause inflammation and infection. This leads to destruction of parts of the surrounding areas of the middle ear as more and more skin cells become trapped causing more inflammation and infection. It occurs predominantly in people who have had multiple ear infections during childhood and ventilation tubes, although it can also occur in those who have never had an ear infection. They occur in about 1 in 20,000 people but are a common presentation to the Stanford Ear Institute. We don’t fully understand why they occur but the main theories include layers underneath the ear-drum becoming sticky or negative pressure within the middle ear pulling the eardrum inwards. The main form of management involves surgery.
Santa Maria PL, Jackler RK. The Cholesteatoma: From Principles to Practice. Chp 12. Otolaryngology Principles and Practice.
Jackler RK, Santa Maria PL, Varsak YK, Nguyen A, Blevins NH. A new theory on the pathogenesis of acquired cholesteatoma: Mucosal traction. Laryngoscope. 2015;125 Suppl 4:S1-S14.