Will cholesteatoma cause damage to middle ear structures?

Question

Hello doctor,

I have had an ear infection (right ear) for the last several months, including fullness, pain in and behind the ear, and foul-smelling discharge. Recently I completed the 10 days dose of Ciprodex drops, and the discharge has cleared, but fullness and pain have not reduced. Recent hearing test also showed mild-moderate hearing loss in the right ear and tinnitus. I have a history of cholesteatoma in the left ear. Doctor noted visualization of granular tissue in the attic during the last appointment and ordered a CT scan to rule out cholesteatoma in the right ear. Is there anything remarkable in either ear on these scans? Any evidence of cholesteatoma? If so, has it done any damage to the middle ear structures? Also, can you tell me what surgery they did on my right ear?

Answer 1

Hi,

Welcome to icliniq.com.

I have seen the CT report. (attachment removed to protect patient identity).

There is a residual soft tissue density in your right middle ear, likely granulation tissue. Additionally, there is right mastoid effusion, meaning air cells in the mastoid bone filled with fluid, Combination of mastoid effusion and middle ear soft tissue results in fullness and may explain the pain. Soft tissue around the middle ear ossicles results in conductive hearing loss. It is expected that you have a mild or moderate hearing loss. Good news, it is usually reversible with regression of granulation tissue. Regarding granulation tissue, it usually regresses and your symptoms usually get better with time.

Regarding evidence of cholesteatoma, there is no evidence of bone resorption. Especially scutum is very well preserved. Unfortunately, this granulation tissue may progress to cholesteatoma, you understand that if your symptoms get worse.

On the left ear, there is evidence of cholesteatoma surgery, partial mastoid resection. Mastoid cavity looks clean. Very minimal soft tissue in the left middle ear. Bilateral inner ear, meaning the sensorial part looks good. Additionally, minimal mucosal thickening in right posterior ethmoidal cells are present.

I hope this helps.