A cholesteatoma consists of squamous epithelium that is trapped within the skull base in the middle ear/mastoid process and can erode and destroy important structures within the temporal bone. It can lead to complications like brain abscess, meningitis, etc and can prove fatal if left untreated.
PROCEDURE
Surgery is performed under general anaesthesia.
There are two basic surgical approaches to the ear:
Transcanal: Performed through the ear canal, specially if the size is very small.
Postauricular: Performed by making an incision behind the ear and moving the ear forward to allow exposure of the mastoid and middle ear.
• If the cholesteatoma is small and can be removed entirely in one piece, the eardrum and the ossicles are reconstructed all in one operation.
• If the cholesteatoma can be removed only in pieces, there is a chance that cholesteatoma may regrow. In this case, remaining fragments which may have grown are removed several months later in repeat surgery, followed by ossicular reconstruction.
• If the cholesteatoma is rather extensive and adherent to the inner ear or facial nerve, it may not be possible to remove the entire cholesteatoma and a radical mastoidectomy is performed. The result is a so-called open cavity which requires life-long follow-up in the ENT outpatient clinic, every few months.
DURATION
The procedure can last from one hour to three hours depending on the size of the cholesteatoma and extent of infection.
RECOVERY
Hospital stay may be of 1-2 days. If the stitches are not dissolvable, they will be removed after one or two weeks. The packing will be removed from the ear after 1 to 3 weeks.
If there is a mastoid cavity after the operation, it will need regular care in the ENT OPD department until it is entirely healed.
Heavy lifting, straining, nose blowing is to be avoided for some time. Routine work can be resumed in 2-3 weeks.
RISKS
- Hearing Loss
- Dizziness
- Facial Paralysis
- Tinnitus
- Recurrence of cholesteatoma