What is this strange lump growing inside your ear? (Cholesteatoma) Let's find out exactly.

Do you sometimes have a foul-smelling discharge from your ear? Or do you often feel a lump or pressure inside your ear? While many people think this is just a simple earache or infection, sometimes it can be something more serious. Today we are going to talk about one such condition. It is called Cholesteatoma. Although the name may sound strange, it is important to know about it.

Simply put, what is Cholesteatoma?

Cholesteatoma is an abnormal growth that develops behind your eardrum (tympanic membrane), in the middle ear. Although it is actually a tumor, it is not cancer. So don't worry about it. It is formed by a collection of dead skin cells. It is similar to the way our dead skin cells collect and form a small lump inside the ear. Over time, this lump of cells gradually grows larger. Sometimes it looks like a pearl, so some people call it a "pearl tumor."

This situation can occur in two main ways:

• Congenital cholesteatoma: Some children can have this growth inside their ear at birth. This is somewhat rare.
• Acquired cholesteatoma: This is the most common type. It occurs over time as a result of other problems in the ear.

What symptoms occur when this condition occurs?

The symptoms of a cholesteatoma can vary slightly depending on whether it is present at birth or develops later. If a young child is born with it, there may be no symptoms until the tumor is large. The child's doctor may first notice it during a routine checkup.

However, in general, the following symptoms can be seen in this condition.

Why does this cholesteatoma form? What are the main causes?

The main reason for this is the eardrum being pulled inward, which is called `(Retracted eardrum)`. Now let's see how that happens.

Imagine, there is a small tube that connects our ears and throat. We call this the Eustachian tube . Its main function is to equalize and balance the air pressure between the middle ear and the outside environment. When we yawn or swallow, we feel a "pop" sound in our ears and it feels like they are opening because this tube is activated.

Now imagine that you have a cold, an allergy, or a sinus problem. What happens is that the Eustachian tube swells and becomes blocked. What happens then? The air stops flowing into the middle ear, and the air there is sucked into the body. As a result , the pressure inside the middle ear decreases, creating a vacuum.

Because of this vacuum pressure, the eardrum, unable to withstand the outside air pressure, is pulled inward at its weakest point. Just like a little air is forced into an empty plastic bottle when it is squeezed.

In addition to this main reason,

• Due to frequent ear infections (Chronic otitis media) .
• Due to an accident such as a ruptured eardrum .
• Very rarely, this condition can occur at birth .

How do you find this, Doctor?

If you have the symptoms mentioned above, you should first see your family doctor. He or she will ask you about your symptoms and whether you have had ear infections before.

Then, the doctor uses a small instrument called an otoscope to examine your ear. He or she can look inside the ear and see if there is a buildup of dead skin cells behind the eardrum or if there is a bulge in the eardrum.

If a cholesteatoma is suspected, your doctor will refer you to an ear, nose, and throat specialist (otolaryngologist or ENT specialist) . The specialist may perform additional tests to confirm the condition and determine the extent of the damage.

• CT scan (Computed Tomography scan): This can clearly see how large the tumor is, whether the very delicate bones called the ossicles inside the ear have been damaged, or whether it has spread to the brain.
• Hearing tests: Various hearing tests are performed to measure how much your hearing has been affected. Tympanometry is a special test that can help diagnose this condition.

What are the treatments for this?

This is a question that many people ask. Can't this be cured by taking medicine?

Medications, especially antibiotics and ear drops, can be given, but they are only given to control the infection caused by the cyst. That is, to temporarily reduce the pus and pain coming from the ear. But medications will never make the cyst go away.

There are two main goals of surgery:

1. Completely removing the cholesteatoma tumor and stopping the spread of the infection.

2. To try to repair the damage to the ear as much as possible and restore hearing.

The surgeries performed for this purpose are called ``Mastoidectomy'' and ``Tympanoplasty.'' The specialist will decide which surgery is most suitable for you based on your condition.

What will happen after surgery? And what to be careful about?

Most people experience complete resolution of symptoms after surgery. However, there is a risk of recurrence of cholesteatoma. Therefore, it is essential to continue to follow-up with your doctor after surgery.

Your specialist will tell you to come back at specific intervals . During these checkups:

• I'm checking my ear again.
• Hearing is being checked.
• Sometimes, a debridement (cleaning) of the ear is performed. This involves carefully removing any dead skin cells and other tissue that may have accumulated.

Can cholesteatoma be prevented?

There is no way to prevent the type that is present at birth. But there are things we can do to reduce the risk of developing the more common, later-onset type.

• Treat ear infections quickly and properly: If you or your child is experiencing frequent ear infections, it is important to seek medical attention to determine the cause and treat them properly. It is also important to treat conditions that impair the function of the Eustachian tube, such as colds and allergies.
• Protecting the Ears: It is also important to protect the ears from things and accidents that could rupture the eardrum.

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