Symptoms of Cholesteatoma
Symptoms of cholesteatoma may be subtle at first but worsen as the growth expands. Since cholesteatoma can erode bone and surrounding structures, its symptoms range from simple hearing issues to more serious neurological signs. Recognising these early signs allows for quicker diagnosis and reduces the risk of permanent complications.
The most common symptom is chronic ear discharge, often foul-smelling and continuous. Unlike occasional fluid drainage from an ear infection, cholesteatoma discharge tends to persist for weeks or months and doesn’t respond to ordinary ear drops. This is due to the trapped, infected keratin debris constantly draining through a hole or retraction in the eardrum.
Another hallmark symptom is hearing loss in the affected ear. Initially, this hearing loss is conductive in nature, caused by the blockage of sound transmission through the ossicles. As the cholesteatoma erodes these small bones, the hearing loss becomes more severe and may also involve sensorineural components if the inner ear is affected.
Symptoms of Cholesteatoma
Many patients report a feeling of fullness or pressure in the ear. This may be accompanied by mild discomfort or the sense that something is stuck. While pain is not a typical early feature, some individuals do report dull aching or sharp episodes, especially if infection is present.
Tinnitus, or ringing in the ear, is another frequent complaint. This may present as a high-pitched whistle or low-frequency humming and can be constant or intermittent. The presence of tinnitus often indicates irritation of the auditory nerve or inner ear.
In advanced cases, the cholesteatoma may extend into the balance organs, leading to dizziness or vertigo. This is particularly concerning as it implies erosion beyond the middle ear into the labyrinth, which may affect spatial awareness and movement coordination.
More severe symptoms include facial muscle weakness or twitching. The facial nerve runs through the middle ear, and cholesteatomas that invade this area may compress or damage it, resulting in drooping or paralysis of facial muscles.
Symptoms of Cholesteatoma
Other signs can include recurrent ear infections, frequent need for antibiotics, and a visible white mass behind the eardrum during an ear exam. In children, delayed speech or poor academic performance may be linked to undiagnosed hearing loss from a growing cholesteatoma.
Not all symptoms occur at once, and some patients experience only one or two signs. Regardless, persistent discharge or progressive hearing changes should always trigger evaluation by an ENT specialist.
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