When the passage that equalizes pressure in your ear functions poorly (Eustachian tube dysfunction) a vacuum can develop in the middle ear
This vacuum sucks areas of the eardrum weakened by repeated ear infections, causing a pouch (ear drum retraction)
An abnormal growth of skin can develop in the pouch behind the eardrum – this is actually a growth of the skin cells of the eardrum collecting and forming what is called a cholesteatoma
A cholesteatoma can damage bone that is near if not treated, causing dizziness, facial nerve damage, deafness, infection and abscess formation
You may need to have surgery to remove the cholesteatoma or infected bone from your ear
Otoscopy showing an ear canal polyp and cholesteatoma
CT scan showing the cholesteatoma
Why is surgery needed?
The primary goal of surgery for cholesteatoma is treating the infection and removing the full extent of the disease
The secondary goal is to restore hearing
An uncontrolled cholesteatoma can lead to serious complications
What happens during tympanomastoid surgery?
Under general anesthesia your surgeon will make an incision behind your ear so that the mastoid bone and middle ear can be reached
Any cholesteatoma and infected bone are then removed
Packing will be placed in your ear to help promote healing
The incision site is then closed with stitches and covered with tape
This surgery is usually done in about two to three hours so you should be able to go home the next day after your surgery
What to expect after surgery
You will wake up in the recovery room after your surgery where you will be monitored by the nurses and anaesthetist
You should be able to go home the next day after your surgery
You will have stitches behind your ear covered with steri strips that will need to be kept on your ear until you come in for your two-week appointment
You will then come back two weeks later to have packing removed from the inside of your ear by your surgeon
You should have little or no pain following surgery
You should also have little or no bleeding following surgery; you should not have any fever and little or no nausea and vomiting
The risks of surgery
Some of the possible risks and complications of are infection, the graft not holding and exposing the hole in the eardrum, further hearing loss, ringing in the ears, dizziness, facial nerve damage or numbness in the outer ear
Also you may experience dry mouth or notice a change in your sense of taste
Post-Op instructions
You will need to avoid getting your ear wet following surgery
When you do take a shower you will need to protect your ear with a cotton ball with a small amount of vaseline on it
Call your ENT surgeon if you develop a fever over 38° C, any uncontrolled pain, or any dizziness that last more than a few hours
Also call if you are having nausea and or vomiting
Before doing any travelling at high altitudes, swimming, scuba diving, or playing contact sports please call and clear this with your ENT surgeon
