What is the cause of cholesteatoma?

The exact cause of cholesteatoma is not fully understood, but multiple factors are believed to contribute to its development:

1. Eustachian Tube Dysfunction: The Eustachian tube is a small channel that connects the middle ear to the back of the throat. When it malfunctions or is blocked, it can cause negative pressure in the middle ear, leading to retraction of the eardrum.

2. Negative Middle Ear Pressure: Prolonged negative pressure in the middle ear can cause the tympanic membrane (eardrum) to retract and form a pocket called a retraction pocket. Over time, this pocket can become filled with keratin debris (shed skin cells), forming a cholesteatoma.

3. Infection and Inflammation: Chronic infections and inflammatory conditions of the middle ear, such as otitis media, can damage the eardrum and middle ear structures, contributing to the development of retraction pockets and cholesteatoma.

4. Genetic Predisposition: Genetic factors may also play a role in cholesteatoma formation, as some individuals may have a genetic susceptibility to developing the condition.

5. External Auditory Canal Obstruction: Blockages in the external auditory canal, such as impacted earwax or foreign bodies, can contribute to the development of cholesteatoma by creating a favorable environment for the accumulation of keratin debris and bacteria.

Overall, cholesteatoma is a complex condition influenced by various factors, including Eustachian tube dysfunction, negative middle ear pressure, infection, genetic predisposition, and external auditory canal obstruction.