Chronic Suppurative Otitis Media
In this condition a hole in the eardrum means that repeated infections are likely particularly when the patient has a cold or gets water in their ears. In the long term it leads to a chronically runny ear and hearing loss. It can also can tinnitus and dizziness. Surgery to repair the hole in the eardrum is usually successful and will often cure the problem unless cholesteatoma is present.
Cholesteatoma is a condition in which skin grows inwards rather than coming out of the ear in wax. As the skin grows into the space behind the eardrum it puts out enzymes which can destroy any kind of tissue. This means that it can erode through even bone causing widespread damage. Apart from some cases of childhood cholesteatoma however damage tends to occur slowly over years rather than months and so can usually be stopped by performing surgery before the disease has progressed too far.
The symptoms of cholesteatoma are:
- Recurrent discharge from the ear
- Hearing loss
- Tinnitus (buzzing in the ear)
In advanced cases the disease can spread to involve the brain or may cause infection in the brain such as an abscess or meningitis. It can also cause profound dizziness, and facial paralysis. These advanced symptoms are however rare, and over the course of the last fifty years are not often seen in UK patients with this condition.
Effective treatment requires surgery. This is to remove the disease and to place grafts in the areas destroyed by disease. The aim of primary surgery is not to restore hearing but to eradicate disease. It is however often possible to perform surgery at a later date, when all disease is definitely gone, to improve hearing.
Are there any risks?
Although operating is the only way of eradicating cholesteatoma, this also carries risks.
There is less than a 1% risk of damage to the facial nerve and so it is extremely rare to hear of someone having facial weakness after this surgery. Hearing loss can occur however when the disease is removed as can dizziness and tinnitus. The risk of hearing loss depends on the exent of the disease, but as mentioned may be amenable to later restorative surgery. Dizziness and increased tinnitus after surgery are extremely rare, occurring in less than 2% of patients.
The nerve of taste for the tongue runs through the middle of the disease site and sometimes must be removed along with the disease. In these cases, the tongue is only affected on the side of the disease. It can still taste normally on the other side. Movement and sensation on the tongue is not affected.
If you would like to arrange a consultation with Mr Banerjee to look into this condition further please contact us.