Pediatric cholesteatoma

What is a pediatric cholesteatoma?

A cholesteatoma is a cyst made up of dead skin cells that continue to shed. It can grow larger and damage the fragile bones of the middle ear. An untreated cholesteatoma growth can lead to balance issues, hearing loss and may also impact facial muscle function.

What are the signs and symptoms of a pediatric cholesteatoma?

Symptoms of cholesteatoma range from mild to severe, depending on how large the cyst is and how long it has been present.

Mild symptoms

• Bad smell coming from the ear

• Dizziness or vertigo (severe spinning, unbalanced feeling)

• Ear discharge (fluid leaks from the ear)

• Numbness in or around the ear

• Pain in or around the ear

• Repeated or lengthy ear infections

• Swelling in the inner ear

Severe symptoms

• Abscesses in the brain (pus pockets from infections)

• Facial muscle paralysis

• Loss of hearing

• Meningitis (brain infection)

What are the causes of a pediatric cholesteatoma?

Cholesteatoma is typically either congenital (present at birth) or is an acquired (developed after birth) problem.

Causes include:

• Congenital cyst - Children may be born with a cholesteatoma cyst.

• Congenital birth defect - Children may be born with a birth defect in the eustachian tube (passage from the back of the nose to the middle of the ear). Normally, the tube allows air to flow naturally through it while equalizing ear pressure. Any change or damage to the tube can create a vacuum that will cause the ear drum to retract and form a cyst in the pocket.

• Acquired cyst - Repeated ear infections or fluid in the middle ear can lead to cysts.

• Acquired eustachian tube defect - Repeated ear infections, colds, sinus infections and severe allergic reactions or symptoms can damage or obstruct air flow in the eustachian tube. The mucous that builds up inside the tube can cause a cyst to form.

• Acquired tympanic membrane perforation (also called ruptured ear drum)

If left untreated, the eardrum tear (rupture) causes dead skin cells to accumulate and creates pressure in the middle ear. This leads to the cholesteatoma and possibly, additional complications (like hearing loss).