Cholesteatoma of the middle ear is the most serious type of inflammatory disease of the middle ear mastoid. If it is considered to be a cholesteatoma, surgery can be considered as soon as possible if the physical condition can tolerate general anesthesia.
What is a cholesteatoma: Cholesteatomas are epithelial lesions that remain in the mastoid cavity of the middle ear and continue to accumulate and eat away at the bone, drilling at the seams and eating at the bones. Although they are not true tumors, they behave like tumors, so they are considered clinically dangerous lesions that require early surgery once detected, and delay may cause serious problems and even endanger life.
Causes of middle ear cholesteatoma formation: There are both congenital and acquired causes. Some of the acquired causes are related to chronic otitis media and tympanic membrane perforation.
Common manifestations of middle ear cholesteatoma.
1. Pus flowing from the ear, sometimes with foul-smelling pus.
2. Stuffy and blocked ears and hearing loss.
3. Ear examination reveals perforation of the relaxed part of the tympanic membrane or perforation of the tense part with white skin inside the tympanic chamber.
4. Thin layer CT of the temporal bone reveals a high-density shadow in the middle ear mastoid with possible bone destruction.
Possible serious consequences of middle ear cholesteatoma.
1. hearing loss.
2. Vertigo.
3. Facial palsy.
4. Labyrinthitis.
5. Meningitis, brain abscess or even death.
Surgery: depending on the early or late detection of the disease and the surgeon’s habits, early stages can have middle ear mastoid completion surgery and hearing reconstruction; if the lesion is too advanced, mastoid radical treatment is needed, which may require hearing sacrifice. In case of facial paralysis or intracranial infection, urgent surgery is required. In order to remove the lesion, hearing is usually reduced after cholesteatoma surgery. If conditions permit, the surgeon will help the patient to preserve or achieve hearing reconstruction as much as possible, but it depends on the intraoperative situation and the extent of the lesion.
Anesthesia: Usually general anesthesia.
Cost: Depending on the extent of the condition and the type of surgery, the cost is usually around several thousand to over 10,000.
Length of hospitalization: usually one week.
Outpatient medication change time: In the case of radical surgery, the surgical cavity needs to regrow a layer of epithelium in order to achieve dry ears, so it also needs to be changed in the outpatient clinic for about a month. This process is also very important for the post-operative results. The doctor is not afraid of the trouble of changing the medication, and the patient’s friends should not be afraid of the trouble.
Possible complications of the surgery: There is a possibility of them occurring because the anatomy of this surgery is very complex and very fine, and the surgeon operates as if he were dancing on the tip of a knife, so the degree of risk is very high. According to the surgical experience of the most authoritative experts in the world, the serious complications that may occur in this surgery include
1, facial paralysis.
2, cerebral crest fluid leakage from the ear.
3, total deafness.
4, intracranial infection.
5, hemorrhage, and other serious complications.
These risks mentioned above are present in every surgery, and the above complications may occur in every new case, and these complications will not be completely avoided because of the surgeon’s skill, there will be a certain probability that for a given patient, the complications will be absent or present, 100%. That is why it is important for patients to have as much knowledge and understanding as possible about this disease and the difficulty of the procedure as well as the risks. Medical technology is not perfect at this time and in the future, there will be many unknown areas and uncertainties, but the responsibility and love of the doctor will be eternal. When it comes to surgery, doctors and patients are comrades in the same trenches, all working toward the same goal!
Precautions after cholesteatoma surgery: Cholesteatoma is prone to recurrence, so be sure to see your clinic regularly after surgery and clean the surgical cavity scabs regularly. In the case of open mastoid cavity, it is important to note that the ear canal should not be filled with water and swimming.
Once cholesteatoma is suspected, try not to delay and make sure to go to a large experienced hospital for timely treatment.