Sack like growth in the ear Discussion

People with long standing fluid in the ear can develop a very serious problem called cholesteatoma. This condition is basically a skin lined sack which is pulled into the middle ear and mastoid cavity by negative pressure in the ear.

The problem usually starts in childhood with fluid in the ears. The child is unable to ventilate (pop) the ear and all the air in the middle ear is slowly absorbed. This leaves a negative pressure in the middle ear which slowly over a period of years pulls the ear drum into the mastoid cavity. The ear drum is pulled through a narrow opening and forms a sack like structure. This sack has a narrow opening, as the lining of the sack is discarded it accumulates and the sack grows. The sack will continue to expand and destroy everything in its path. This disease is most commonly seen in adults because cholesteatoma takes years to develop.

Patients commonly have complaints of hearing loss, ear drainage and occasional pain. On examination of the ear there will be white cheesy type material in the canal and possibly greenish drainage from infection.

Treatment for this problem is surgical removal which involves doing mastoid surgery. The patient may continue to have difficulties with that ear for the rest of their lives.

This type of problem is becoming less frequently seen. Ear doctors have prevented the development of cholesteatoma by using middle ear ventilation tubes in children.  The tubes eliminate fluid in the ears, allow ventilation of the middle ear space and prevent the ear drum from being sucked up into the mastoid cavity.

There is a variation of cholesteatoma which is different from the other disease process. This form is called congenital cholesteatoma and is thought to arise from a trapped island of skin in the middle ear. The island of skin forms a cyst and starts to grow. The collection of material within the cyst is white in color. The cyst will continue to grow in the middle ear and destroy everything in its pathway, including the middle ear bones. Surgical removal is the only treatment. The cyst can reoccur after surgery. (This condition is not associated with fluid in the ears.)