Cholesteatoma: Why One-Sided Hearing Loss Could Be More Than Just Earwax

We often hear people say, “Maybe it’s just earwax,” when someone experiences hearing problems in one ear. And indeed, earwax can be the cause — but not always.

There’s a less-known but serious condition called cholesteatoma. It’s not cancer, but it can permanently damage your hearing if left untreated.

Let’s take a closer look at cholesteatoma: what it is, the symptoms, and why it’s important to check your ears beyond just cleaning out wax.

What Is Cholesteatoma?

Cholesteatoma is a growth of skin tissue in the middle ear. Although it sounds like a “tumor,” cholesteatoma is not cancerous. However, its growth can destroy important structures in the ear, including the eardrum and the small bones that help us hear.

This growth happens slowly and often unnoticed, so many people only realize it once hearing loss has started.

What Causes It?

There are two types of cholesteatoma:

• Congenital: Present from birth, usually found in children with no prior history of ear infections.
• Acquired: More common. Typically develops after chronic ear infections or Eustachian tube problems.

Symptoms to Watch For

Cholesteatoma may be symptom-free initially. But if left untreated, you might notice:

• Hearing loss in one ear
• Fullness or pressure in the ear
• Foul-smelling discharge from the ear
• Dizziness or imbalance
• Recurring ear infections

Who Can Be Affected?

Cholesteatoma can affect anyone — male or female, children or adults.

Facts:

• Children with frequent ear infections are at higher risk
• Studies in the UK and Denmark show a slight male predominance, but many females are also diagnosed
• In Saudi Arabia, nearly 50% of cholesteatoma patients are female (Source: PubMed)

Can It Be Diagnosed on Your Own?

It’s difficult. Cholesteatoma cannot be seen from the outside. Even doctors need special tools, such as a video otoscope, to clearly see inside the ear.

Other supporting tests:

• Tympanometry – measures ear pressure
• Audiometry – measures hearing thresholds
• CT Scan – checks for bone damage in the ear

How Is It Treated?

Cholesteatoma cannot heal on its own. Surgery is usually required:

• Mastoidectomy: Removes the infected tissue
• Tympanoplasty: Repairs the eardrum or hearing bones

After surgery, patients need regular check-ups to prevent recurrence.

Real-Life Example: Michelle’s Case

We often see patients with hearing issues in one ear. Many think it’s just earwax.

That was the case with Michelle. When examined, her eardrum wasn’t visible. We used a video otoscope so she could see it herself.

“This isn’t earwax, ma’am. It looks like a cholesteatoma — a skin growth in the middle ear,” we explained.

Fortunately, it was detected early. Michelle was immediately referred to an ENT specialist, and because it was caught in the early stage, her chances of recovery are high.

Conclusion: Don’t Ignore One-Sided Hearing Loss

• Hearing loss in one ear is not always caused by earwax
• Cholesteatoma can affect anyone
• Special tools are needed to see it
• Early treatment = lower risk of complications