The epithelial layer covering the skin of the ear canal (external ear canal) and the outer surface of the eardrum is largely the same as the skin covering the outer surface of our body. The component called keratin, which constitutes the main substance of our nails and hair and gives the skin its hardness, is produced by the cells on the skin surface. If the epithelial layer lining the ear canal and the outer surface of the membrane somehow enters the middle ear cavity, it will continue to produce keratin there. This substance, which is completely foreign to the middle ear, causes a serious reaction there. When the skin epithelium of the ear canal and eardrum enters the middle ear cavity and adheres there, it is called cholesteatoma.
Over time, as the cholesteatoma tissue grows in the middle ear and its related cavities, the infection caused by the keratin it produces and the microbes added to it have a destructive, destructive effect. starts to show. Temporal bone (ear bone):
- Middle ear cavity,
- Mastoid cavity and their associated tiny spongy air cells
- From the eardrum to the inner ear window Three tiny ossicles (hammer, anvil, stirrup - malleus, incus, stapes) that extend and are responsible for transmitting sound vibrations to the inner ear fluids.
- Facial nerve, internal carotid artery (carotid artery leading to the brain) and sigmoid sinus. – It contains vital structures such as the jugular bulbus (the vein that carries blood from the brain to the heart)
. In addition, the temporal lobe of the brain, the cerebellum and the meninges surrounding them are the neighbors of the ear bone. Cholesteatoma has the possibility of damaging all these vital structures.
Cholesteatoma primarily causes damage to the thinnest, sensitive parts of the ossicular system in the middle ear and causes a decrease in hearing over time. In addition, it acts like a tumor, gnawing away at the ear bone from the inside, and can cause problems in the above-mentioned structures, the consequences of which can be fatal.
How does cholesteatoma form in the middle ear?
Cholesteatoma in the middle ear is one of the following processes: It occurs as a result of one of the following:
- Congenital skin epithelial residues in the middle ear cavity can lead to cholesteatoma.
The thin and weak upper part of the eardrum collapses inward, becomes a pocket, and begins to cover the recesses in the middle ear. Then look inside these recesses. Swelling skin epithelium and bacteria added to the keratin produced form cholesteatoma. - Skin epithelium enters through the holes located in the wall part of the eardrum close to the ear bone and causes cholesteatoma.
- Eardrum perforation and As a result of surgeries performed for chronic otitis media, the skin epithelium covering the outer surface of the external ear canal and membrane unintentionally enters the middle ear cavity and causes cholesteatoma there over time.
What symptoms does cholesteatoma cause?
Patients with clesteatoma often come to the physician with complaints such as hearing loss that has been present for a long time and increases over time, and especially occasional foul-smelling ear discharge. Untreated cholesteatoma may also present to the physician with complaints of brain abscess, meningitis, facial paralysis, and severe dizziness and hearing loss due to inner ear damage.
How is cholesteatoma diagnosed?
Cholesteatoma is often diagnosed. It is recognized by an experienced ear, nose and throat physician during an ear examination. There is no need to take a biopsy as is done for tumors to confirm the diagnosis. However, it may be necessary to resort to computerized ear tomography to understand the spread of cholesteatoma and sometimes to diagnose it if it cannot be clearly seen during examination.
What is the treatment of cholesteatoma?
Cholesteatoma, like chronic otitis media, is a disease that can be treated surgically. . What needs to be done is to completely clean the cholesteatoma covering the middle ear and ear bone cavities and, if possible, to repair the ossicles and eardrum in the middle ear and create a new middle ear cavity that will transmit sound vibrations to the inner ear. During these surgeries, special precautions are taken to protect the facial nerve passing through the ear bone.
What happens if cholesteatoma is not treated?
Acting like a tumor, cholesteatoma destroys the ear bone and the structures in the middle ear that provide hearing. proceeds by . If not treated in time, it can lead to very serious consequences such as facial paralysis, meningitis, brain or cerebellum abscess, inner ear damage and permanent hearing loss. Therefore, cholesteatoma is a disease that must be treated surgically when diagnosed.
Read: 0
