Chronic Otitis Media and Cholesteatoma

A child with a hole in the eardrum can get chronic otitis media – a hole in the eardrum, long-standing infections, and drainage from the ear canal (otorrhea). The infection slowly wears away the middle ear bones.
 
Chronic otitis media can also lead to a cholesteatoma. A cholesteatoma is a skin cyst behind the eardrum. Poor Eustachian tube function may be the cause. Over time, the cholesteatoma increases in size and destroys the delicate middle ear bones. 
 
Both chronic otitis media and cholesteatoma can go into the inner ear. This can cause lasting hearing loss, dizziness and facial paralysis. If the disease spreads into the brain, other serious health problems can occur.
 

Evaluating Your Child for Chronic Otitis Media and Cholesteatoma

To determine if your child has chronic otitis media and cholesteatoma, the Children’s Hearing Center team will:

• Evaluate your child’s hearing
• Examine your child’s ear with a microscope
• Request a computed tomography (CT) scan, if needed, to determine the extent of the disease. The CT scan can also provide images to guide surgery.

The only treatment for chronic otitis media and cholesteatoma is a surgery called tympanoplasty with mastoidectomy. There are no medicines that will cure these diseases. 
 

Chronic Otitis Media and Cholesteatoma Surgery Outcomes

The primary goal of surgery for chronic otitis media and cholesteatoma is to remove all infection and cholesteatoma. Hopefully, this will stop the ear from draining and prevent additional problems. A good result can be expected in 80-90 percent of the cases. In many cases, a second surgery is needed to look for recurrence of the disease. This surgery is usually performed 6-18 months after the first surgery.
 
The secondary goal is to improve hearing. However, failure to improve hearing is not a complication.
 
Success depends almost as much on the ability of the body to heal and preserve the reconstruction as on the surgeon's skill.  Fortunately, even those cases that fail may often be revised. 
 
Eardrum hole repair. The rate of successful repair of a hole in the eardrum is typically 90-95 percent. The success rate improves if the ear is dry and uninfected. If your child has already had one surgery that did not work, the success rate of further surgery is lower. Some children have such poor Eustachian tube function that complete repair is impossible.