Ear ringing, hearing loss, or constant ear discharge… These complaints can sometimes be harbingers of cholesteatoma, a “hidden guest” in your ear. Cholesteatoma is a non-malignant but serious health problem-inviting tissue that can progress in the middle ear and cause bone erosion. No more postponing! At our private clinic in Istanbul, Cholesteatoma Surgery offered with our experienced ENT specialists and advanced technology equipment both protects your hearing and improves your quality of life.

What is Cholesteatoma Surgery?

Cholesteatoma is the name given to a cystic mass consisting of dead skin cells that develops in the middle part of the ear, usually due to chronic ear infections. This mass, which can erode bone structures over time, can lead to hearing loss, balance problems, headaches, and rarely serious complications extending to the brain membrane.

Cholesteatoma Surgery is a surgical procedure that ensures complete removal of this pathological tissue under microscope and reshaping of the middle ear air space. The goal is both to radically clean the cyst and to optimize your hearing function.

Why Choose Cholesteatoma Surgery?

  • Permanent Solution: Since cholesteatoma is a progressive condition that doesn’t resolve with medication, surgery is the only cure.
  • Hearing Comfort: After cyst cleaning, middle ear ventilation improves, your hearing threshold values approach normal.
  • Reducing Complication Risk: Early intervention eliminates the risk of spread to brain membrane, facial nerve, or inner ear.
  • Minimal Recurrence Rate: We reduce recurrence chances by completely cleaning tissue using microsurgical technique and intraoperative high-resolution microscope.
  • Fast Recovery: Our endoscopic or open mastoid surgery techniques provide return to daily life within 3-5 days depending on operation scope.
  • Multidisciplinary Approach: We guarantee both functional and aesthetic results with hearing tests, radiological planning, and plastic-reconstructive methods when necessary.

Who Can Have Cholesteatoma Surgery?

  • Those with long-term and recurring ear infections
  • Those experiencing ear discharge, hearing loss, or ringing (tinnitus)
  • Patients who previously had tympanoplasty or mastoid surgery with suspected recurrence
  • Individuals developing balance loss, dizziness, or facial nerve symptoms
  • Anyone with cystic lesion detected in middle ear on radiological (CT/MR) examination

Note: Findings indicating middle ear involvement in your hearing tests or radiologically detected cyst presence absolutely require surgical intervention. Early diagnosis and treatment both prevent complications and increase your recovery speed.

Pre-Surgery Preparation Process

1. Detailed Consultation and Imaging

Your hearing level is measured with audiometry and tympanometry.

Cyst spread, bone erosion, and neighboring structure relationship are clarified with high-resolution CT/MR images.

2. General Health Assessment

Surgical safety is ensured with blood tests, coagulation profile, and internal medicine/cardiology consultation if necessary.

3. Resolution of Accompanying Problems

If there’s foreign body, periostitis, or active infection in ear canal, it’s treated first and then surgery is planned.

4. Motivation and Information

Procedure steps, risks, expected recovery process, and follow-up appointments are transparently explained; no questions remain with our “Transparent Financing” and “No Postponement” policies.

How is Cholesteatoma Surgery Performed?

1. Endoscopic Microsurgery

  • Incision and Access: Endoscopic opening with minimal 1-2 cm incision from behind ear auricle.
  • Cyst Excision: Cyst is completely removed with high-resolution endoscope; tympanoplasty (tympanic membrane repair) is applied if necessary.
  • Advantage: Less tissue damage, fast healing, minimal scarring.

2. Open Mastoid Surgery

  • Classic Mastoidectomy: Access to mastoid air cells and middle ear is provided with wider incision from behind ear.
  • Cholesteatoma Resection & Reconstruction: Bone erosion is repaired, hearing is optimized with tympanoplasty or ossicular reconstruction.
  • Advantage: Ideal for chronic cases with extensive spread or requiring defect repair.

In both techniques, we use intraoperative neuromonitoring and high-resolution microscope to both protect healthy tissue and completely clean cholesteatoma. Operation duration varies between 2-4 hours.

The Importance of Doctor Selection

Cholesteatoma surgery aims to both preserve hearing function and prevent skull base complications. Therefore:

  • ENT Specialist (Head-Neck Surgery): Accredited expertise in cholesteatoma and mastoid surgery
  • Microsurgery and Endoscopic Experience: Certificate in high-resolution microscope and endoscope use
  • Multidisciplinary Collaboration: Joint planning with radiology, neurology, plastic-reconstructive team
  • Transparent Communication: Sincere approach that clearly explains risks, success rates, recovery process

Our team with these criteria guarantees the safest and most comfortable process for you.

What Awaits the Patient on Surgery Day?

1. Morning Preparations and Anesthesia Consultation:

Blood pressure, pulse, oxygen saturation measurement

Briefing before general anesthesia and sharing final information

2. Operation:

Meticulous 2-4 hour surgery; facial nerve is protected with intraoperative neuromonitoring

3. Recovery and Initial Observation:

Emergence from anesthesia, monitoring of bleeding and vital signs

4. Discharge or Admission:

Usually same-day discharge for endoscopic cases; 2-3 night observation for mastoid approaches

5. Head and Ear Care:

Head bandage, behind-ear dressing; dressing change instructions are clearly given.

Recovery and Follow-up Process

  • Days 1-7: Mild pain and slight serous discharge are normal; prescribed painkiller and antibiotic use.
  • Week 2: Sutures or staples are removed; middle ear ventilation is checked.
  • Months 1-3: Regular audiological tests and tympanometry for hearing follow-up.
  • Months 6-12: Radiological examination (CT) for recurrence control; revision planned if necessary.
  • Annual Check-ups: First 2 years are the most critical period; follow-up examination every 6 months is recommended.

Frequently Asked Questions

1. Does cholesteatoma surgery completely restore hearing?

Hearing improves significantly in most patients; however, some losses due to bone damage may be permanent.

2. Can the facial nerve be damaged?

Working with experienced hands and neuromonitoring reduces facial nerve damage risk to minimal level.

3. Will there be surgical scars?

Incision is very small in endoscopic technique; behind-ear scar in mastoid surgery fades over time.

4. What is the recurrence risk?

Recurrence rate drops to 10-15% with microsurgical and endoscopic cleaning; regular follow-up is critical.

5. How long does the procedure take and when can I return to daily life?

2-4 hour operation, possibility to return to work/school and social life within 3-5 days.