Cholesteatoma in Children

Abnormal growths known as cholesteatomas can threaten your child's hearing. A cholesteatoma involves skin-like tissue growing in the ear. The growths fill the space left when infection or congenital ear problems cause a small hole in the ear. Cholesteatomas are slow growing, but early diagnosis and treatment is best to help protect a child's hearing.

• Can cholesteatomas threaten your child's hearing?

Types

• There are two main types of cholesteatomas found in children. The first, acquired cholesteatoma, occurs when a child has chronic middle ear infections. A diagnosis of the second type, congenital cholesteatoma, is made if a child has no history of ear infection, but still develops the symptoms of cholesteatoma. Physicians will generally treat both types in the same manner.

Risks

• If untreated, a cholesteatoma can cause the delicate ear bones to decay, damaging the middle ear and causing hearing loss. Cholesteatomas can also obstruct the eustachian tube in the ear, which also leads to hearing difficulties. A cholesteatoma can also cause dizziness and facial paralysis in rare instances. Cholesteatomas may grow more aggressively in children than adults. Children also face a higher risk of having the condition return after treatment.

Treatment

• Cholesteatomas can be difficult to diagnosis. Children may not feel pain or complain of hearing loss. In many cases, a cholesteatoma can be diagnosed during a routine check-up in a doctor's office. If your doctor suspects cholesteatoma, he or she may order a CAT scan to determine the extent of the problem. Antibiotics and ear irrigation are often the first steps in treatment. The goal is to control infections and prevent additional tissue growth. More advanced cases may require hospitalization, IV therapy or even surgery to control infections, remove excess tissue and preserve hearing.

Statistics

• A long-term study of pediatric cholesteatoma cases was published in the April 2002 issue of the Archives of Otolaryngology--Head Neck Surgery. It found that almost three-fourths of all cases involve boys. The average age of diagnosis was five years. In most cases, hearing loss was rated as slight or moderate.

Prevention

• Controlling inner-ear infections may help prevent cholesteatoma. If a doctor orders antibiotics or other treatment for infection, be sure the child completes the entire treatment, even after the symptoms disappear. Taking your child for check-ups when your doctor recommends them will provide opportunities for cholesteatoma to be identified and treated at an early stage.