Can cholesteatoma recur after surgery?

Question

Hello doctor,

I have been experiencing persistent symptoms for a few weeks now. Upon using a camera to examine my ear, I noticed structures that appear similar to pearls. Given my medical history, I had cholesteatoma as a child, for which I underwent surgical removal. It appears that these symptoms may indicate a recurrence of cholesteatoma.

Additionally, I want to mention that I am currently taking the tablet Quetiapine. Considering this situation, I am seeking guidance on the appropriate steps needed to address the potential recurrence of cholesteatoma and manage my symptoms effectively. Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thank you for your query.

I have reviewed your medical history of cholesteatoma surgery. There is a possibility of recurrence, given the nature of this condition.

To provide you with the most accurate advice, could you please provide more details about your current symptoms and the time frame of your surgery? Additionally, if you could clarify whether your previous surgery was a canal wall up or canal wall down mastoidectomy, it would help in a better understanding of your situation.

Thank you for sharing the image (attachments removed to protect the patient’s identity), although it only shows a portion of the eardrum and cavity. However, from the visible parts, there are no evident features suggestive of cholesteatoma. The findings appear more consistent with a post-operative ear that has undergone cartilage tympanoplasty, which is a common reconstruction procedure after cholesteatoma surgery.

Given that the entire eardrum is not visible, there might be residual issues that are not apparent in the image. For a comprehensive evaluation, it is recommended to consult an ENT (ear, nose, and throat) surgeon who would use a microscope to thoroughly examine the ear and possibly suggest an MRI (magnetic resonance imaging) of the middle ear and temporal bone to rule out any recurrence.

I suggest you schedule a follow-up appointment with either myself or another ENT specialist to discuss your previous surgery details, and your current symptoms, and undergo a thorough assessment to determine the appropriate management.

If you have any further questions or concerns, please feel free to ask.

Thank you.