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Choleasteatoma is an abnormal skin growth (squamous epithelium) in the middle ear behind the eardrum. A rare congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones. The sequence of events begins with eustachian tube dysfunction which leads to negative pressure in the middle ear.
A large or complicated cholesteatoma usually requires surgical treatment to protect the patient from serious complications. Reconstruction of the middle ear is not always possible in one operation; therefore, another operation may be performed six to 12 months later. After surgery, follow-up OPD visits are necessary to evaluate results and to check for recurrence.
The patient’s canal wall up mastoidectomy was converted to a canal wall down mastoidectomy.
In a canal wall down operation the entire mastoid is exteriorized into the ear canal and the posterior and superior portion of the ear canal is removed down to the region of the facial nerve. Dr Paulose FRCS, DLO is a Consultant ENT Plastic & Laser Surgeon with over 38 years of world class experience in Ear, Nose, Throat and Laser Surgery treating patients across the world from UK, US, Middle East to Asia.

Medical history, your current and past these abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia because of the multifactorial nature. Please note that all the support groups listed are independent and are not part of, or affiliated to, We apologise if you find any contact details that are out of date, incorrect or there are other groups which we don't know about.
Initial treatment may consist of a careful cleaning of the ear, antibiotics, and ear drops. The primary purpose of surgery is to remove the cholesteotoma to eliminate the infection and create a dry ear.
This operation will attempt to restore hearing and, at the same time, allow the surgeon to inspect the middle ear space and mastoid for residual cholesteatoma.
In cases requiring the creation of an open mastoidectomy cavity, OPD visits every few months are needed to clean out the mastoid cavity and prevent new infections. Cholesteatomas often develop as cysts or pouches that shed layers of old skin like onion skin, which build up inside the middle ear. These tests are performed to determine the hearing level in the ear and the extent of destruction the cholesteatoma has caused.

A second stage surgery is sometimes necessary both to ensure that the cholesteatoma is gone as well as to attempt reconstruction of the damaged middle ear bones in an effort to improve hearing. This leaves a large cavity called a mastoid bowl which has to be cleaned by the doctor every 3 to 12 months. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear leading to hearing loss. In order to clean this cavity, the meatus or the external opening into the ear canal is surgically widened a€“Meatoplasty.
Permanent hearing loss, dizziness, and facial muscle paralysis are rare, but can result from continued cholesteatoma growth.

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