If the eardrum and three small ear bones become chronically infected, perforations in the ear drum and/or destruction of the small ear bones can result. Scar tissue formation can also cause hearing problems. Any of these conditions can create conductive hearing loss.

Conductive hearing loss occurs when something interferes with the transmission of sound waves from the outside world to the cochlea. In chronic ear disease, the scar tissue may block the sound waves, or destruction of the ear bones or perforations of the ear drum may prevent effective transmission.

Less frequently, cholesteatoma (growth of eardrum skin in the middle ear chamber) can result from chronic ear disease. Cholesteatoma is treated surgically – the misplaced tissue is removed to prevent serious complications such as deafness, facial weakness, permanent dizziness and abscesses in the brain.

Most commonly symptoms of a Cholesteatoma are blocked ears with other symptoms including hearing loss, pain, discharge and bleeding.

Often a patient has a history of childhood ear infections. The chief complaint is usually recurring ear infections, a blocked ear or hearing loss.

A hole in the ear drum in the roof of the ear (the attic) or the margin of the ear (marginal perforation) is characteristic of the disease.

A CT Scan (computed tomography or Xray of the ear) confirm the disease by showing a destruction of middle ear structures. A hearing test sometimes shows a hearing loss, which is usually conductive in nature.

Yes, a cholesteatoma can be painful if the lesion is infected or growing towards the lining of the brain or nerves. Frequently however there is little to no pain.

There are risks with any operation but generally the cholesteatoma surgery is considered low risk when performed by a trained otologist

If left unattended the cholesteatoma lesion can grow and damage critical structures such as the inner ear (hearing and balance), facial nerve (causing facial weakness) and the brain (causing meningitis or brain abscesses).

Surgery has been the recommended option for cholesteatoma for decades, since the use of the operating microscope became commonplace. It is necessary to eliminate the bacterial colonization and to remove the epithelium from the mastoid bone and middle ear to prevent serious complications. However, surgery can now also reconstruct the part of the hearing mechanism which has been damaged by the disease process.

The diseased bone is drilled out and prosthetic ear bones made of teflon and titanium can replace any diseased ear bones in the middle ear; alternatively cartilage may be used or the bone may be refashioned, sculpted or relocated. Tissue(fascia) grafts made of a layer of muscle and a layer of cartilage are used to repair the perforation in the eardrum.This may be done at one sitting.

To prevent the formation of scar tissue and help normalise middle ear function, a thin silastic sheet is often inserted behind the eardrum. If the chronic ear disease has progressed to fill the ear with scar tissue or new bone formation (tympanosclerosis) or if the ear bones have been completely destroyed, we will perform the operation in two stages. At first, the disease and the diseased mastoid bone is removed and later silastic sheet will be inserted to allow normal healing without scar tissue formation. In the next operation, the silastic sheet is removed and prosthetic ear bones will be placed in an attempt to restore hearing. It won’t be known until the time of your first surgery whether it will be necessary to separate the two stages of the operation.

To prevent the formation of scar tissue and help normalise middle ear function, a thin silastic sheet is often inserted behind the eardrum. If the chronic ear disease has progressed to fill the ear with scar tissue or new bone formation (tympanosclerosis) or if the ear bones have been completely destroyed, we will perform the operation in two stages. At first, the disease and the diseased mastoid bone is removed and later silastic sheet will be inserted to allow normal healing without scar tissue formation. In the next operation, the silastic sheet is removed and prosthetic ear bones will be placed in an attempt to restore hearing. It won’t be known until the time of your first surgery whether it will be necessary to separate the two stages of the operation.

Some symptoms are common to all ear operations, including:

Dry Mouth and Taste Disturbances

Your mouth may feel dry and taste may be disturbed for several weeks after the device is implanted.

Loss of Surface Sensation

You may lose surface sensation on your outer ear following cochlear implant surgery, in small areas or across the entire ear. This usually resolves spontaneously within 6 months to 3 months after surgery.

Tinnitus

Tinnitus does not usually improve immediately after surgery, but usually decreases in proportion to the hearing improvement obtained. If the hearing remains unimproved following surgery for chronic ear disease, the tinnitus will remain or sometimes worsen.

Pain and Stiffness of the Ear and Jaw

Pain and stiffness in the ear and jaw are common following surgeries for chronic ear disease. Ear pain and jaw pain can worsen when you chew or move your neck, and will persist for at least 7 days after the surgery. It can be controlled with pain killers, and any remaining stiffness should subside within 4 to 8 weeks.

As the ear heals, itching is common. As nerve fibres regrow into the new tissue, occasional sharp shooting pains are common.

Facial nerve weakness

On a very miniscule percentage there is a risk of developing facial nerve weakness causing asymmetry of facial features due to injury to the nerve if the nerve is involved in the disease process.