Cholesteatoma

What is a cholesteatoma?

A cholesteatoma is a build-up of skin in the middle ear and mastoid bone behind the eardrum. It is not a cancer, but it slowly grows and can damage the hearing bones, the balance organ and the facial nerve, and it causes repeated infection. It usually starts from a retraction pocket in the eardrum, and can occur at any age.

Symptoms

• Ear discharge that keeps coming back, often smelly, despite antibiotic drops

• Gradual hearing loss in one ear

• Fullness or pressure in the ear

• Occasionally dizziness, and rarely facial weakness

• In children it may be found on a routine ear check

Diagnosis

Cholesteatoma is diagnosed by examining the ear under a microscope or endoscope. A CT scan shows the bone anatomy, and a specialised MRI (non-EPI diffusion-weighted imaging) can detect cholesteatoma as small as 2–3 mm – useful both before surgery and to check for disease returning afterwards.

Treatment

Surgery is the only effective treatment. The aims are a safe, dry ear free of disease, then preserving or improving hearing. Depending on how far the cholesteatoma has spread, options include:

• Endoscopic (keyhole) ear surgery through the ear canal, which gives an excellent view of hidden areas of the middle ear

• Canal wall up mastoidectomy, which keeps the normal shape of the ear canal

• Canal wall down mastoidectomy, with or without mastoid obliteration, which lowers the chance of recurrence

• Reconstruction of the hearing bones, at the same time or as a planned second stage

Dr Reddy completed fellowship training in complex otology in London and uses endoscopic techniques where they suit the disease.

Recovery and follow-up

Most people go home the same day or the next morning and return to work or school within 1–2 weeks. The ear must be kept dry for several weeks. Because cholesteatoma can return years later, long-term follow-up with ear checks, hearing tests and MRI scans is important – often avoiding the need for a routine “second-look” operation.

Frequently asked questions

Is cholesteatoma cancer? No. It is a benign growth of skin, but it needs treatment because it slowly damages the ear.

Can it be treated with antibiotics? Drops can settle infection, but they do not remove a cholesteatoma. Surgery is needed.

Will my hearing improve? It depends on how much damage has already occurred. Removing disease safely comes first; hearing reconstruction is planned where possible.

Can children have cholesteatoma? Yes. Children’s cholesteatoma can be more active, and Dr Reddy treats children at Sydney Children’s Hospital and privately.

Patient information sheet

Download the Cholesteatoma information sheet (PDF).

Please note: the sheet is a general summary of the published medical literature. The figures describe groups of patients and are not specific to your condition – Dr Reddy will discuss your own situation and options with you.

Where Dr Reddy sees patients

Dr Reddy sees adults and children at Macarthur ENT in Gregory Hills and Campbelltown, and at My-ENT in the Sydney CBD (Macquarie Street). He operates at Sydney Children’s, Prince of Wales and Liverpool hospitals (public) and Camden Surgical, Sydney Southwest Private, Prince of Wales Private and St Luke’s hospitals (private).

Referral

GPs, paediatricians and other specialists can refer via HealthLink (Macarthur ENT EDI: macarent; My-ENT EDI: myentdr), email referrals@drrithvikreddy.com or use the online referral form. A current referral from a GP or specialist is needed for a Medicare rebate.

Dr Rithvik Reddy

Expert ENT services for adults and children.

Contact for appointments

Referring doctors can email referrals@drrithvikreddy.com to make appointment

Macarthur ENT

Shop 2101, Level 2, 31A Lasso Rd, Gregory Hills NSW 2557

Suite 102, Building B, Level 1, 4 Hyde Parade, Campbelltown NSW 2560

Phone (02) 4625 1682 · Fax (02) 4625 1032

Mon–Fri 8am–5pm

My-ENT, Sydney CBD

Suite 303, Level 3, BMA House, 135 Macquarie Street, Sydney NSW 2000

Phone (02) 9247 1762 · Fax (02) 9247 2141

Mon–Fri 8:30am–5pm

© 2026 Dr Rithvik Reddy. All rights reserved.