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Repeated ear infections can weaken the eardrum. When the tube that equalizes pressure in the ear (Eustachian tube) functions poorly due to a cold or allergy, a vacuum can occur in the middle ear. This vacuum sucks areas of the eardrum weakened by infection, causing a pouch or abnormal growth of skin behind the eardrum. This is actually ingrowth of the skin of the eardrum itself, and often it develops into a cyst.

This growth is called a cholesteatoma (pronounced coal-est’-e-uh-toe’-ma). Cholesteatomas can cause bone erosion. As a result, the infection can spread to the inner ear or the brain. If cholesteatomas are not treated, deafness, brain abscess, meningitis or death can occur.


• Drainage from the ear, often with a foul odor

• Fullness or pressure in the ear

• Hearing loss

• Aching behind or in the ear

• Dizziness

• Muscle weakness of the face on side of affected ear


The ENT Surgeon will usually cleanse the ear carefully, then prescribe antibiotics by mouth or by ear drops or both. He will note the size of the cholesteatoma and the appearance of the ear. He may order hearing tests or balance tests as well CT scans of the mastoid bone. These tests help the doctor to evaluate the extent of damage caused by the cholesteatoma. A small cholesteatoma may be monitored, but large cholesteatomas are removed surgically. This eliminates the source of the infection. The surgeon will attempt to rebuild the inner ear at that time if damage is not too severe.

In some cases, a second operation several months later may be required to rebuild the inner ear and restore hearing. Sometimes cholesteatomas recur and the physician will monitor closely to evaluate any new growth