Cholesteatoma: a growth behind the eardrum that needs treatment
A cholesteatoma is an abnormal collection of skin cells in the middle ear. It is not cancer, but it slowly grows and can damage the delicate structures of the ear, so it needs to be assessed and treated by an ENT specialist.
Skin in the wrong place.
Normally, the skin of the ear canal and eardrum sheds and migrates outwards. In a cholesteatoma, skin collects in a pocket behind or within the eardrum instead, often after long-term Eustachian tube problems or repeated ear infections. It forms a growing sac of skin cells.
Over time the sac can become infected and wear away the tiny bones of hearing and the bone around the middle ear. That is why it causes hearing loss and discharge, and why, if left untreated, it can lead to dizziness, facial weakness or, rarely, more serious infections.
It can occur at any age, often in people with a history of ear infections or ear problems.
Ear drops can settle infection, but surgery is usually needed to remove it.
Signs of cholesteatoma.
Tick any that apply.
See your GP, who can refer you to ENT. If we see signs that could be a cholesteatoma at an appointment, we explain what we have seen and write to your GP the same day.
How it is treated.
An ENT specialist will examine the ear, often with a microscope, and may arrange a hearing test and a CT or MRI scan to see how far it has spread.
Treatment is usually surgery to remove the cholesteatoma and make the ear safe, sometimes followed by a second operation to check for regrowth or rebuild the hearing bones. Infection may be treated with ear drops and regular cleaning beforehand.
After surgery, hearing in that ear may be better, the same or reduced, depending on how much damage there was. Hearing aids, including bone conduction options arranged by ENT, can help.
Spotting it, referring it, and supporting your hearing.
We look at the ear canal and eardrum as part of every hearing test and earwax appointment.
If something looks like it could be a cholesteatoma, we stop, explain, and write to your GP straight away.
A full test before and after treatment shows how your hearing has been affected.
If hearing is reduced after treatment, we can advise on hearing aids that suit your ear.
Get urgent medical help if you have ear discharge and
- A severe headache, stiff neck or high temperature
- Weakness or drooping on one side of your face
- Severe dizziness or vomiting
- Swelling or redness behind the ear
- Confusion or drowsiness
Call NHS 111, or 999 in an emergency. These can be signs that an ear infection has spread.
Frequently asked questions.
No. It is a benign collection of skin cells, but it does grow and can damage the ear, so it needs treatment.
No. It usually keeps growing slowly unless it is removed.
Yes, it can regrow, which is why follow-up appointments and sometimes a second operation are needed.
Hearing in the affected ear is often reduced. After surgery it may improve, stay the same or get worse, depending on the damage. Hearing aids can help.
Ear cleaning in a cholesteatoma ear should be done by ENT. If you have or might have one, tell us before any appointment.
Check your hearing.
Hearing tests in our Birmingham clinic or at home, with an ear examination included.
Ear dischargeEar infectionsPerforated eardrumConductive hearing lossAll ear conditions
Written and clinically reviewed by our HCPC registered audiologists. Last reviewed: 15 October 2026. This page is general information, not a diagnosis. If you are worried about your hearing or your ears, book an appointment or speak to your GP.