This picture shows two ear drums parallel to each other. In the left ,a normal drum covered with normal skin is depicted. In the right , a skin pocket filled with dead cells seen towards the upper part of the drum. This is called Cholesteatoma. This skin pocket can grow deeper within the bone causing harm to the structures it comes across. It can grow closer to the membranes covering the brain. When these membranes are penetrated, infections can spread to the brain. It can also damage the  nerve supplying the muscles of the face causing paralysis of face. (facial nerve palsy) When cholesteatoma grows in to the inner ear, it can cause deafness and giddiness.


Main clinical feature of cholesteatoma is scanty smelly ear discharge. Therefore patients are not bothered to seek medical advice until they get complications like vertigo, paralysis of face,headache and  fits due to brain infections and deafness.


When a patient with a cholesteatoma is referred to an ENT clinic, doctor can confirm the findings under the microscope. A hearing assessment is done. Cat scan or MRI may help to confirm the diagnosis.

Treatment is eradication of disease by an operation called mastoidectomy. Whole skin pocket is removed by drilling the temporal bone , taking utmost care to protect the facial nerve,the inner ear structures, and the membranes of the brain.The patient has to be kept under close surveillance even after the operation to asses recurrence of disease.

Mastoidectomy Patient Education Leaflet in Sinhala