What is the treatment for a cholesteatoma?

Eric E. Smouha, MD
Ear, Nose & Throat (Otolaryngology)

The treatment of cholesteatoma is always surgical. It usually involves raising the eardrum and opening the bone behind the ear to remove the growth (tympano-mastoidectomy). We try to reconstruct the eardrum and hearing apparatus at the time of surgery to manage the disease in a single-stage operation if at all possible, and we have been successful in the majority of cases.

The operation is done in the hospital under general anesthesia and takes approximately three hours. Most patients go home the same day and return to work or school after one week. Cholesteatomas can re-grow in the best of hands, so close follow-up every six months for several years after surgery is advisable.

Surgery is almost always necessary to treat cholesteatoma. During the surgical procedure, the cyst is removed. There are several types of surgeries that are available for this procedure. Surgery may be performed in several locations in the ear, and the ear may be accessed through the ear canal or through a slit behind the ear. These decisions are made based on the size of the cyst as well as the size of the ear. In some cases, restorative surgery is also available in order to restore hearing.

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