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A cholesteotoma is a type of benign tumor1 of the middle ear cavity. Ordinarily, the lining of the middle ear (the cavity behind the eardrum) is the same sort of tissue as lines the nose and sinus cavities. It is termed a mucous membrane, moist and soft, a distinct type of lining from the hard, tough skin of the esterior body surfaces (stratified squamous epithelium). That type of skin lines the outer ear canal. It constantly sheds the top layer
A cholesteotoma is formed when a perforation of the eardrum allows this different type of skin to invade the lining middle ear space during the process of healing. This abnormally placed skin sheds flakes of the hard, dead top layer. This material accumulates, clogging the middle ear canal with a pearly white debris. This "crud" accumulates because it has nowhere to go. It causes pressure effects on local middle ear structures, harbors bacteria and most significantly is thought to release an enzyme that can destroy bone tissue.
Cholesteotoma is a serious condition which can lead to destruction of the internal ear structures and deafness, or purulent labyrinthitis, facial paralysis, or bacterial infections including meningitis, brain and other abscesses within the skull cavity. The treatment is surgical.
1. Benign tumors are not cancerous in the sense of invading and spreading through the tissues of the body directly or by metastasis. However, they can cause significant problems by local pressure effects on surrounding tissue.