How is Cholesteatoma diagnosed?

How is Cholesteatoma Diagnosed?

Cholesteatoma is a condition characterized by the abnormal growth of skin cells in the middle ear. It typically occurs as a result of repeated ear infections or a perforated eardrum. If left untreated, cholesteatoma can lead to hearing loss, dizziness, and other complications. Therefore, early diagnosis is crucial for effective treatment.

Diagnosing cholesteatoma involves a combination of medical history evaluation, physical examination, and various diagnostic tests. The process is typically carried out by an otolaryngologist, also known as an ear, nose, and throat (ENT) specialist. Let's explore the different methods used to diagnose cholesteatoma:

1. Medical History Evaluation:

The first step in diagnosing cholesteatoma is discussing the patient's medical history. The ENT specialist will inquire about symptoms such as ear pain, hearing loss, recurrent ear infections, and any previous ear surgeries. This information helps the doctor understand the patient's condition better and guides further diagnostic procedures.

2. Physical Examination:

During the physical examination, the ENT specialist will carefully examine the patient's ears using an otoscope. This handheld instrument allows visualization of the ear canal and eardrum. The doctor will look for signs of cholesteatoma, such as a retracted eardrum, visible skin growth, or discharge. They may also assess the patient's hearing ability using a tuning fork or other hearing tests.

3. Endoscopy:

In some cases, the ENT specialist may perform an endoscopy to get a closer look at the middle ear. This procedure involves inserting a thin, flexible tube with a light and camera (endoscope) through the nose or a small incision in the ear canal. It allows the doctor to examine the structures of the middle ear and detect any abnormalities, including cholesteatoma.

4. Imaging Tests:

Imaging tests play a crucial role in confirming the presence of cholesteatoma and determining its extent. The most commonly used imaging techniques include:

• Computed Tomography (CT) Scan: A CT scan provides detailed cross-sectional images of the ear and helps identify the size, location, and extent of the cholesteatoma. It can also reveal any associated complications, such as erosion of nearby bones or the presence of fluid.


• Magnetic Resonance Imaging (MRI): An MRI uses powerful magnets and radio waves to create detailed images of the soft tissues in and around the ear. It is particularly useful for evaluating the extent of cholesteatoma and detecting any associated complications, such as damage to the facial nerve.

5. Audiometry:

Audiometry tests are conducted to assess the patient's hearing ability. These tests help determine the severity of hearing loss and whether it is caused by cholesteatoma or other factors. Pure-tone audiometry involves wearing headphones and listening to different tones at varying volumes. Speech audiometry assesses the patient's ability to understand spoken words at different volumes.

6. Cultures and Biopsies:

In some cases, the doctor may collect a sample of the ear discharge or tissue for laboratory analysis. This can help identify any underlying infections or determine if the growth is cancerous. Cultures and biopsies are typically performed when there are atypical symptoms or if the cholesteatoma is recurrent.

Once the diagnosis of cholesteatoma is confirmed, the ENT specialist will discuss the treatment options with the patient. Treatment may involve a combination of medication, such as antibiotics or ear drops, and surgical intervention to remove the cholesteatoma and repair any damage to the ear structures.