Otitis media means “inflammation of the middle ear”, as a result of a middle ear infection. It can occur in one or both ears. Otitis media is the most frequent diagnosis for children who visit physicians for illness. It is also the most common cause of hearing loss in children. Although otitis media is most common in young children, it occasionally affects adults.

Is it serious?

Yes, because of the severe earache and hearing loss it can cause. Hearing loss, especially in children, may impair learning capacity and even delay speech development. However, if it is treated promptly and effectively, hearing can almost always be restored to normal. Otitis media is also serious because the infection can spread to nearby structures in the head, especially the mastoid. (see the symptoms list below). Immediate attention from your doctor is the best action.

How does the ear work?

The outer ear collects sounds. The middle ear is a pea-sized, air-filled cavity separated from the outer ear by the paper-thin eardrum. Inside the middle ear are three tiny ear bones. When sound waves strike the eardrum, it vibrates and sets the bones in motion that transmit to the inner ear. The inner ear converts vibrations to electrical signals and sends these signals to the brain. A healthy middle ear has the same atmospheric pressure as air outside of the ear, allowing free vibration. Air enters the middle ear through the narrow eustachian tube that connects the back of the nose to the ear.

What causes otitis media?

Blockage of the eustachian tube during a cold, allergy or upper respiratory infection, and the presence of bacteria or viruses lead to a build-up of pus and mucus behind the eardrum. This infection is called acute otitis media. The build-up of pressurized pus in the middle ear causes pain, swelling and redness. Since the eardrum cannot vibrate properly, hearing problems may occur. Sometimes the eardrum ruptures, and pus drains out of the ear. More commonly, however, the pus and mucus remain in the middle ear due to the swollen and inflamed eustachian tube. This is called middle ear effusion or serous otitis media. Often after the acute infection has passed, the effusion remains lasting for weeks, months or even years. This condition allows frequent recurrences of the acute infection and may cause difficulty in hearing.

What will happen at the doctor’s office?

During an examination, the doctor will use an otoscope to look at and assess the ear. The doctor checks for redness in the ear, and/or fluid behind the eardrum, and to see if the eardrum moves. These are the signs of an ear infection. Two other tests may also be performed:

  • Audiogram – tests if hearing loss has occurred by presenting tones at various pitches.
  • Tympanogram – measures the air pressure in the middle ear to see how well the eustachian tube is working and how well the eardrum can move.

How should medication be taken?

It is important that all the medications be taken as directed and that you keep any follow-up visits. Often, antibiotics to fight the infection will make the earache go away rapidly, but the infection may need more time to clear up. Other medications that your doctor may prescribe include an antihistamine (for allergies), a decongestant (especially with a cold) or both. Sometimes the doctor may recommend a medication to reduce fever and/or pain. Special ear drops can ease the pain. Call your doctor if you have any questions about your or your child’s medication, or if symptoms do not clear.

What other treatment may be necessary?

If your child experiences multiple episodes of acute otitis media within a short time, or hearing loss, or chronic otitis media lasts for more than three months, your physician may recommend referral to an otolaryngologist for placement of ventilation tubes, also called pressure-equalization (PE) tubes. This is a short surgical procedure in which a small incision is made in the eardrum, any fluid is suctioned out, and a tube is placed in the eardrum. This tube eventually will fall out on its own and the eardrum heals. There is usually an improvement in hearing and a decrease in further infections with PE tube placement.
Otitis media may recur as a result of chronically infected adenoids and tonsils. If this becomes a problem, your doctor may recommend removal of one or both. This can be done at the same time as ventilation tubes are inserted.

What are the symptoms?

In infants and toddlers, look for: pulling or scratching at the ear, especially if accompanied by other symptoms, hearing problems, crying, irritability, fever, ear drainage.

In young children, adolescents and adults look for: earache, feeling of fullness or pressure, hearing problems, dizziness, loss of balance, nausea, vomiting, ear drainage and/or fever.

Remember, without proper treatment, damage from an ear infection can cause chronic or permanent hearing loss.

© 2016 American Academy of Otolaryngology – Head and Neck Surgery

Feeling unsteady or dizzy can be caused by many factors such as poor circulation, inner ear disease, medication usage, injury, infection, allergies and/or neurological disease. Dizziness is treatable, but it is important for your doctor to help you determine the cause so that the correct treatment is implemented. While each person will be affected differently, symptoms that warrant a visit to the doctor include a high fever, severe headache, convulsions, ongoing vomiting, chest pain, heart palpitations, shortness of breath, inability to move an arm or leg, a change in vision or speech, or hearing loss.

What is dizziness?

  • Dizziness can be described in many ways, such as feeling lightheaded, unsteady, giddy or feeling a floating sensation. Vertigo is a specific type of dizziness experienced as an illusion of movement of one’s self or the environment. Some experience dizziness in the form of motion sickness, a nauseating feeling brought on by the motion of riding in an airplane, a roller coaster or a boat. Dizziness, vertigo and motion sickness all relate to the sense of balance and equilibrium. Your sense of balance is maintained by a complex interaction of the following parts of the nervous system:
    The inner ear (also called the labyrinth), which monitors the directions of motion, such as turning, rolling, forward-backward, side-to-side and up-and-down motions.
  • The eyes, which monitor where the body is in space (i.e., upside down, right side up, etc.) and also directions of motion.
  • The pressure receptors in the joints of the lower extremities and the spine, which tell what part of the body is down and touching the ground.
  • The muscle and joint sensory receptors (also called proprioception) tell what parts of the body are moving.
  • The central nervous system (the brain and spinal cord), which processes all the information from the four other systems to maintain balance and equilibrium.

The symptoms of motion sickness and dizziness appear when the central nervous system receives conflicting messages from the other four systems.

What causes dizziness?

Circulation: If your brain does not get enough blood flow, you feel lightheaded. Almost everyone has experienced this on occasion when standing up quickly from a lying-down position. But some people have light-headedness from poor circulation on a frequent or chronic basis. This could be caused by arteriosclerosis or hardening of the arteries, and it is commonly seen in patients who have high blood pressure, diabetes or high levels of blood fats (cholesterol). It is sometimes seen in patients with inadequate cardiac (heart) function, hypoglycemia (low blood sugar) or anemia (low iron).

Certain drugs also decrease the blood flow to the brain, especially stimulants such as nicotine and caffeine. Excess salt in the diet also leads to poor circulation. Sometimes circulation is impaired by spasms in the arteries caused by emotional stress, anxiety and tension.

If the inner ear fails to receive enough blood flow, the more specific type of dizziness – vertigo – occurs. The inner ear is very sensitive to minor alterations of blood flow and all of the causes mentioned for poor circulation to the brain also apply specifically to the inner ear.

Neurological diseases: A number of diseases of the nerves can affect balance, such as multiple sclerosis, syphilis, tumors, etc. These are uncommon causes, but your doctor may perform certain tests to evaluate these.

Anxiety: Anxiety can be a cause of dizziness and lightheadedness. Unconscious overbreathing (hyperventilation) can be experienced as overt panic, or just mild dizziness with tingling in the hands, feet or face. Instruction on correct breathing technique may be required.

Vertigo: An unpleasant sensation of the world rotating, usually associated with nausea and vomiting. Vertigo usually is due to an issue with the inner ear. The common causes of vertigo are (in order):

  • Benign Positional Vertigo: Vertigo is experienced after a change in head position such as lying down, turning in bed, looking up or stooping. It lasts about 30 seconds and ceases when the head is still. It is due to a dislodged otololith crystal entering one of the semicircular balance canals. It can last for days, weeks or months. The Epley “repositioning” treatment by an otolaryngologist is usually curative. BPV is the commonest cause of dizziness after (even a mild) head injury.
  • Ménière’s disease: An inner ear disorder with attacks of vertigo (lasting hours), nausea or vomiting, and tinnitus (loud noise) in the ear, which often feels blocked or full. There is usually a decrease in hearing as well.
  • Migraine: Some individuals with a prior classical migraine headache history can experience vertigo attacks similar to Ménière’s disease. Usually there is an accompanying headache, but can also occur without the headache.
  • Infection: Viruses can attack the inner ear, but usually its nerve connections to the brain, causing acute vertigo (lasting days) without hearing loss (termed vestibular neuronitis). However, a bacterial infection such as mastoiditis that extends into the inner ear can completely destroy both the hearing and equilibrium function of that ear, called labyrinthitis.
  • Injury: A skull fracture that damages the inner ear produces a profound and incapacitating vertigo with nausea and hearing loss. The dizziness will last for several weeks and slowly improve as the other (normal) side takes over. BPV commonly occurs after head injury.
  • Allergy: Some people experience dizziness and/or vertigo attacks when they are exposed to foods or airborne particles (such as dust, molds, pollens, dander, etc.) to which they are allergic.

When should I seek medical attention?

Call 911 or go to an emergency room if you experience:

  • Dizziness after a head injury,
    Fever over 101° F, headache or very stiff neck,
  • Convulsions or ongoing vomiting,
  • Chest pain, heart palpitations, shortness of breath, weakness, a severe headache, inability to move an arm or leg, change in vision or speech, or
  • Fainting and/or loss of consciousness

Consult your doctor if you:

  • Have never experienced dizziness before,
  • Experience a difference in symptoms you have had in the past,
  • Suspect that medication is causing your symptoms, or
  • Experience hearing loss.

How will my dizziness be treated?

The doctor will ask you to describe your dizziness and answer questions about your general health. Along with these questions, your doctor will examine your ears, nose and throat. Some routine tests will be performed to check your blood pressure, nerve and balance function, and hearing. Possible additional tests may include a CT or MRI scan of your head, special tests of eye motion after warm or cold water or air is used to stimulate the inner ear (ENG – electronystagmography or VNG – videonystagmography), and in some cases, blood tests or a cardiology (heart) evaluation. Balance testing may also include rotational chair testing and posturography. Your doctor will determine the best treatment based on your symptoms and the cause of them. Treatments may include medications and balance exercises.

Prevention tips:

  • Avoid rapid changes in position
  • Avoid rapid head motion (especially turning or twisting)
  • Eliminate or decrease use of products that impair circulation, e.g., tobacco, alcohol, caffeine and salt
  • Minimize stress and avoid substances to which you are allergic
  • Get enough fluids
  • Treat infections, including ear infections, colds, flu, sinus congestion and other respiratory infections

If you are subject to motion sickness:

  • Do not read while traveling
  • Avoid sitting in the rear seat
  • Do not sit in a seat facing backward
  • Do not watch or talk to another traveler who is having motion sickness
  • Avoid strong odors and spicy or greasy foods immediately before and during your travel
  • Talk to your doctor about medications

Remember: Most cases of dizziness and motion sickness are mild and self-treatable. But severe cases and those that become progressively worse deserve the attention of a doctor with specialized skills in diseases of the ear, nose, throat, equilibrium and neurological systems.

© 2016 American Academy of Otolaryngology – Head and Neck Surgery

How does the ear hear sounds?

The ear can be divided into three parts: 1) the external ear includes the pinna (outer, visible ear) and the ear canal, 2) the middle ear includes the tympanic membrane (ear drum) and the ossicles (middle ear bones), 3) the inner ear, which includes the cochlea (organ of hearing) and vestibule (organ of balance).
Sound waves enter the ear canal and cause a vibration of the tympanic membrane (ear drum) which is then passed through three tiny bones behind the ear drum in the middle ear space: the malleus (hammer), incus (anvil) and stapes (stirrup). The sound vibrations in the ossicles are then transmitted to the nerves and fluids in the cochlea (inner ear), which generates a nerve impulse that passes along the auditory nerve to the brain.

What are the types of hearing loss?

Hearing loss can be divided into two types: Conductive Hearing Loss, which is essentially a mechanical problem with the conduction of sound vibrations, and Sensorineural Hearing Loss, a problem with the generation and/or transmission of nerve impulses from the inner ear to the brain. Mixed hearing loss refers to a combination of these two types. The preliminary classification of hearing loss as conductive or sensorineural can be determined by a physician using a tuning fork in the office. A formal audiogram, or hearing test, is the best way to determine the type and degree of hearing loss. The distinction between these two types of hearing loss is important because many cases of conductive hearing loss can be improved with medical or surgical intervention. An otolaryngologist, also called an ear, nose and throat (or ENT) doctor, can determine the specific diagnosis and treatments for either type of hearing loss and perform surgical treatments, if necessary.

What can cause Conductive Hearing Loss?

Conductive hearing loss may result from diseases that affect the external ear or middle ear structures. Some of the causes of conductive hearing loss include:

Problems with the External Ear

  • Cerumen (ear wax) obstruction: Ear wax can be identified by a medical examination and can usually be removed quickly. This condition may actually be aggravated by cotton tipped applicators (Q-tips) that many patients use in an attempt to clean their ears.
  • Otitis Externa: Often referred to as “swimmer’s ear”, an infection of the ear canal may be related to water exposure. Although the most common symptoms of otitis externa are pain and tenderness of the ear, conductive hearing loss can also occur if there is severe swelling of the ear canal.
  • Foreign body in Ear Canal: This is also readily identified on examination and can usually be cleared in the office. Occasionally, a brief anesthesia is required for this procedure in children. Common foreign bodies include beads and beans in children and cotton or the tips of cotton-tipped applicators in adults. Uncommonly, the foreign object is a live bug such as a cockroach which can cause itching, pain and noise.
  • Bony lesions of Ear Canal: These are benign growths of bone along the walls of the ear canal resulting in a narrowing of the ear canal which may then lead to frequent obstruction from a small amount of wax or water. These bony lesions can generally be managed with vigilant cleaning of ear wax to prevent obstruction. In rare cases these lesions require surgical removal.
  • Atresia of the Ear Canal: Complete malformation of the external ear canal is called atresia. It may be seen along with complete or partial malformation of the pinna (outer ear) and is noted at birth. It is rarely associated with other congenital abnormalities and is most often only on one side (unilateral). Management of congenital aural atresia is complex. Surgical treatment may be beneficial to either reconstruct the ear canal in select cases or to implant a device that vibrates the bone of the ear directly.

Problems with the Middle Ear structures

  • Middle Ear Fluid or Infection (otitis media): The middle ear space may be filled with fluid instead of air. Otitis media is divided into three types: acute otitis media, serous otitis media (middle ear fluid) or chronic otitis media. Acute otitis media occurs rapidly, is painful and may cause fever. Serous otitis media often follows an acute otitis media infection or may occur on its own. Both conditions are common in children and are related to an inability to ventilate the middle ear space due to poor Eustachian tube function (the channel which connects the middle ear space with the nasal passage). Otitis media may be treated medically or with a myringotomy with tube insertion (also known as an M&T or ear tube surgery). In most adults, an M&T surgery may be performed in the office. In children, a brief general anesthesia is usually required. Chronic otitis media is associated with damage to the ear drum or ossicles (middle ear bones), and frequently requires surgery.
  • Tympanic Membrane Atelectasis or Retraction (collapse of the ear drum): Poor Eustachian tube function may also result in excessive negative pressure behind the ear drum causing the ear drum to collapse onto the middle ear bones. Severe retraction of the ear drum may necessitate ear tube surgery or a surgery to rebuild the ear drum (tympanoplasty).
  • Tympanic Membrane Perforation: A hole in the ear drum due to infections or trauma may result in hearing loss as the sound vibrations are not effectively captured by the damaged ear drum. A tympanoplasty is the surgical repair of the ear drum. Generally, this is an outpatient surgery performed by an otolaryngologist with a very high success rate (over 90%).
  • Cholesteatoma: This may develop when the ear drum collapses to the point that the outer skin of the ear drum grows into the middle ear and becomes trapped. In spite of the ending of the word cholesteatoma, this is not a tumor but a benign collection of skin that can cause destruction of the middle ear structures and, if left untreated, more serious problems. This is almost always a surgical disease and may require a staged surgical approach (more than one surgery) in order to safely remove the cholesteatoma and restore hearing by repairing the damaged middle ear bones.
  • Damage to the Middle Ear Ossicles: This may result from trauma, infection, cholesteatoma or a retracted ear drum leading to conductive hearing loss. Surgical reconstruction of the ossicular chain is often successful in restoring hearing in these cases.
  • Otosclerosis: This is an inherited disease in which the bone around the stapes bone hardens and the stapes fails to vibrate effectively. The conductive hearing loss slowly progresses in early adulthood. It affects women more often than men and affects slightly less than 1% of the population overall. This condition may be treated with a hearing aid or with a stapedectomy surgery which is highly effective in restoring hearing in most cases.

Many types of hearing loss can also be ameliorated with the use of conventional hearing aids. In addition, many implantable hearing devices are available for various types of hearing loss. An otolaryngologist can determine the specific cause of the hearing loss, advise patients of their treatment and rehabilitative options, and help patients achieve the best possible hearing outcome and hearing related quality of life.

© 2016 American Academy of Otolaryngology – Head and Neck Surgery

Un crecimiento anormal de piel en el oído medio detrás de la membrana del tímpano es un colesteatoma. Infecciones repetidas y/o una bolsa de retracción de la membrana timpánica pueden causar que la piel se engrose y forme un saco de expansión. Los colesteatomas generalmente se desarrollan como quistes o bolsas que descaman capas de piel vieja, que crece dentro del oído medio. A lo largo del tiempo, el colesteatoma puede aumentar su tamaño y destruir los huesecillos vecinos del oído medio. La pérdida auditiva, mareos, y parálisis de los músculos faciales son raros, pero pueden ser el resultado del continuo crecimiento del colesteatoma.

¿Por qué se origina un colesteatoma?

Un colesteatoma usualmente se origina debido a una pobre función de la trompa de Eustaquio así como por una infección de oído medio. La trompa de Eustaquio conduce aire desde la parte posterior de la nariz hacia el oído medio para igualar la presión del oído (destapa los oídos). Cuando la trompa de Eustaquio trabaja inadecuadamente, tal vez debido a una causa alérgica, un resfrío o sinusitis, el aire en el oído medio es absorbido por el cuerpo, creando un vacío parcial en el oído. Este vacío succiona formando una bolsa o saco a partir de la membrana timpánica, especialmente en áreas debilitadas por una infección previa. Esto puede desarrollar el saco y transformarse en un colesteatoma. Una forma rara congénita de colesteatoma (presente al nacimiento) puede ocurrir en el oído medio y en otros lugares, como en la proximidad de los huesos del cráneo. Sin embargo, el tipo de colesteatoma asociado a infecciones del oído es el más común.

¿Como se trata un colesteatoma?

Un examen por parte de un otorrinolaringólogo-cirujano de cabeza y cuello puede confirmar la presencia de un colesteatoma. El tratamiento inicial consiste en una limpieza cuidadosa del oído, antibióticos y gotas ópticas. La terapia tiende a detener la supuración del oído controlando la infección. Las características del crecimiento del colesteatoma deben ser también evaluadas.

Un colesteatoma grande o complicado usualmente requiere tratamiento quirúrgico para proteger al paciente de complicaciones graves. Exámenes de audición y equilibrio, radiografías de la mastoides (el hueso del cráneo cercano al oído), y Tomografías de la mastoides pueden ser necesarias. Estos exámenes son realizados para determinar el nivel de audición en el oído y la extensión de la destrucción que el colesteatoma ha causado.
La cirugía es realizada con anestesia general en la mayoría de los casos. El objetivo primario de la cirugía es remover el colesteatoma para que drene el oído y la infección sea eliminada. La preservación o restauración de la audición es el segundo objetivo de la cirugía. En casos de severa destrucción del oído, la reconstrucción puede no ser posible.

La reparación del nervio facial o procedimientos para controlar el mareo son raramente necesarios. La reconstrucción del oído medio no es siempre posible en un solo tiempo quirúrgico, por lo tanto una segunda cirugía puede ser necesaria dentro de los 6 a 12 meses. Esta segunda operación intentará restaurar la audición y, al mismo tiempo, permitirá al cirujano inspeccionar el espacio del oído medio y mastoides buscando partes residuales del colesteatoma.

La cirugía puede hacerse algunas veces en forma ambulatoria. Para ciertos pacientes una noche de internación es necesaria. En algunos raros casos de infección grave se necesitará una hospitalización prolongada para tratamiento antibiótico. El tiempo de licencia laboral común es de una a dos semanas.

Después de la cirugía, el seguimiento en consultorio es necesario para evaluar resultados y para evaluar una posible recidiva. En casos donde se haya creado una cavidad abierta de mastioidectomia, el seguimiento en consultorio cada pocos meses es necesario para limpiar la cavidad mastoidea y prevenir nuevas infecciones. Algunos pacientes necesitarán exámenes periódicos de su oído a lo largo de su vida. El colesteatoma es una condición seria del oído pero tratable que puede ser diagnosticada sólo con un examen médico. Dolor persistente en el oído, supuración, presión en el oído, pérdida de audición, mareos o debilidad de los músculos de la cara deben ser evaluados por un otorrinolaringólogo.

Síntomas y riesgos

Inicialmente el oído puede supurar con feo olor. A medida que la bolsa o saco del colesteatoma se agranda puede causar una sensación de presión o de oído lleno, acompañado de pérdida en la audición. Un dolor detrás o dentro del oído, especialmente de noche puede causar una molestia considerable.

El mareo o la debilidad en los músculos de una mitad de la cara (la mitad del lado del oído infectado) puede también ocurrir. Cualquiera de estos síntomas son buenas razones para buscar una evaluación médica.

El colesteatoma puede ser peligroso y nunca debe ser ignorado. La erosión del hueso puede hacer que la infección se extienda a áreas vecinas, incluyendo el oído interno y el cerebro. Si no es tratado, la sordera, abscesos de cerebro, meningitis y raramente la muerte pueden ocurrir.
Más información acerca del oído.

© 2016 American Academy of Otolaryngology – Head and Neck Surgery

An abnormal skin growth in the middle ear behind the eardrum is called cholesteatoma. Repeated infections and/or a tear or pulling inward of the eardrum can allow skin into the middle ear. Cholesteatomas often develop as cysts or pouches that shed layers of old skin, which build up inside the middle ear. Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear leading to hearing loss that surgery can often improve. Permanent hearing loss, dizziness and facial muscle paralysis are rare, but can result from continued cholesteatoma growth.

What causes a cholesteatoma?

A cholesteatoma usually occurs because of poor eustachian tube function as well as infection in the middle ear. The eustachian tube conveys air from the back of the nose into the middle ear to equalize ear pressure (“clear the ears”). When the eustachian tubes work poorly, perhaps due to allergy, a cold or sinusitis, the air in the middle ear is absorbed by the body, creating a partial vacuum in the ear. The vacuum pressure sucks in a pouch or sac by stretching the eardrum, especially areas weakened by previous infections. This can develop into a sac and become a cholesteatoma. A rare congenital form of cholesteatoma (one present at birth) can occur in the middle ear and elsewhere, such as in the nearby skull bones. However, the type of cholesteatoma associated with ear infections is most common.

How is cholesteatoma treated?

An examination by an otolaryngologist – head and neck surgeon can confirm the presence of a cholesteatoma. Initial treatment may consist of a careful cleaning of the ear, antibiotics and ear drops. Therapy aims to stop drainage in the ear by controlling the infection. The growth traits of a cholesteatoma must also be evaluated.

A large or complicated cholesteatoma usually requires surgical treatment to protect the patient from serious complications. Hearing and balance tests, and CT scans (3-D x-rays) of the mastoid may be necessary. These tests are performed to determine the hearing level in the ear and the extent of destruction the cholesteatoma has caused.

Surgery is performed under general anesthesia in most cases. The primary purpose of surgery is to remove the cholesteotoma to eliminate the infection and create a dry ear. A second surgery is sometimes necessary both to ensure that the cholesteatoma is gone as well as to attempt reconstruction of the damaged middle ear bones in an effort to improve hearing. In cases of severe ear destruction, reconstruction may not be possible. Facial nerve repair or procedures to control dizziness are rarely required. Reconstruction of the middle ear is not always possible in one operation; therefore, another operation may be performed six to 12 months later. This operation will attempt to restore hearing and, at the same time, allow the surgeon to inspect the middle ear space and mastoid for residual cholesteatoma.

Surgery is commonly performed in an out-patient setting. For some patients, an overnight stay is necessary. In rare cases of serious infection, prolonged hospitalization for antibiotic treatment may be necessary. Time off from work is typically one to two weeks. After surgery, follow-up office visits are necessary to evaluate results and to check for recurrence. In cases requiring the creation of an open mastoidectomy cavity, office visits every few months are needed to clean out the mastoid cavity and prevent new infections. Some patients will need lifelong periodic ear examinations.

Symptoms and dangers

Initially, the ear may drain fluid with a foul odor. As the cholesteatoma pouch or sac enlarges, it can cause a feeling of fullness or pressure in the ear, along with hearing loss. An ache behind or in the ear, especially at night, may cause significant discomfort.

Dizziness, or muscle weakness on one side of the face (the side of the infected ear) can also occur. Any or all of these symptoms are good reasons to seek medical evaluation.

Cholesteatoma is a serious but treatable ear condition, which can be diagnosed only by medical examination. Bone erosion can cause the infection to spread into the surrounding areas, including the inner ear and brain. If untreated, deafness, brain abscess, meningitis and, rarely, death can occur.

© 2016 American Academy of Otolaryngology – Head and Neck Surgery