Cholesteatomas and Ossiculoplasty

It is not uncommon for skin cysts to form inside the structures of the ear.  CNC Hearing & Balance Center Neurotologist Moises Arriaga, MD discusses the condition known as Cholesteatoma and a procedure to to surgically address these noncancerous cysts called Ossiculoplasty.

Sometimes chronic infections of the ear or problems with the Eustachian tube can create  a skin cyst on the ear. We call those skin cysts Cholesteatomas. These are not tumors. These are not cancerous. This is normal skin of the eardrum or ear canal that has accumulated behind the ear drum. The problem is the skin can dissolve the hearing bones and can dissolve to go back into the mastoid bone and even create problems with the nerve that moves the face, go in to the inner ear or even cheat into the brain area right above the ear. The kind of symptoms that people show when they have cholesteatoma are hearing loss associated with ear pain, drainage and frequent infections. One of the most characteristic findings is if a patient has a scab on the eardrum that just won’t go away despite cleaning and wax, sometimes that means that scab is the tip of the iceberg of a cyst that goes further in. In those situations in addition to examining the ear with a microscope in the office we will often get a CAT scan and or an MRI  to help us define it further. So to treat these, we need to remove that abnormal skin. Sometimes that means we have to reconstruct the little hearing bones. Reconstructing the hearing bones is called Ossiculoplasty. We will often do that with either a plastic or metal hearing bone and also steal a little bit of the cartilage from the ear to cover that hearing bone to protect it from coming through the new eardrum. It is effective but sometimes it requires two separate steps. The first step, to make the ear safe and the second step, to make sure there are no hidden roots of skin coming out. The way we make sure that doesn’t happen is we will sometimes put a little piece of plastic behind the eardrum and then returned 6 months to a year later. If there is any root growing back, it will hit the plastic andform a little pearl that we will just pluck out. We call that staging the operation and about 10% of our patients who have a skin cyst or a cholesteatoma  need that staging strategy.

What we are also able to do either in the first operation or the second operation is replace any of the little hearing bones that have been dissolved by the infection in the cholesteatoma and that is a nice strategy for returning the vibrations all the way to the inner ear.

Act now and get your hearing problems addressed. Call our clinic at 504-934-8320 for an appointment with one of our audiologists or to schedule a free hearing screening. CNC Hearing and Balance Center has locations in Marrero, Uptown New Orleans and Mandeville.