Cholesteatoma is a destructive and expanding epithelial cyst in the middle ear and/or mastoid process. Cholesteatomas are not cancerous butresult in the destruction of the bones of the middle ear (ossicles), as well as grow through the base of the skull into the brain. They can become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal.SURGERY of Cholesteatoma
The treatment of a cyst is total excision but if complete excision is not possible incomplete excision will result in recurrence so exteriorization (Marsupialisation) has to be done.PRINCIPLES of treatment-
1. Squamous epithelium must be excised in Total or Exteriorized.
2. Endothelium must be excised in total or interiorized i.e. put into communication with the Eustachian tube.
3. Purulent mastoiditis must be treated and Choleasteatoma cleared & cured before tympanoplasty.
When the patient has large hole in the ear drum, it is unlikely to close by medicines and will require an operation to close it. If the hole in the drum is not closed by operation, even though medicines and injections may temporarily stop the discharge, the hole will remain open, so that every time you get dirty water into the ear or develop a cold, the discharge is likely to recur.
Recurrent infections cause progressive deafness due to fixation (tympanosclerosis or destruction of the ossicular chain).What is Tympanoplasty?
It is necessary to clear the underlying infection in the mastoid, correct ossicular defects and close the hole in the drum in order to restore hearing and prevent recurrent ear discharge, by a special operation known as Tympanoplasty
The operation is performed under local anaesthesia (except in children), You will be required to stay few hours in hospital.Tips for preventing discharge and hearing loss
Do not use drops if there is no discharge as severe deafness due to inner ear damage can occur.
Keep the ear constantly plugged by a large clean cotton wool ball (a small plug should not be used as it likely to fall inside) which should be changed 3 times daily. This is to prevent dirt, soap water etc. from entering.
Do not blow the nose during a cold prevent infection from nose being forced up into the ear.RECURRENCE OF DISCHARGE IN C.S.O.M.
Every time dirty water goes into an ear with a hole in the drum, it will go straight through the hole in the drum into the middle ear and set up infection. Operative closure of the perforation is important as it prevents recurrence of discharge . Every time a patient with a perforated drum develops a cold and blows his nose, there is through and through passage of a stream of air with pus from the nose up the Eustachian Tube into the ear with recurrence of ear discharge. After operative closure of the perforation, this through and through passage of a stream of air is stopped.
Dr. Harish Nanda, Consulting Otorhinolarygologist is known for his excellent rapport with his patients. He did his graduation & post graduation from Dayanand Medical College and Hospital Ludhiana in 1998.Since then he has worked under some of the top specialists in his field, which include fellowships under Dr. Heine Stamburger from Austria .He did his senior residency at Batra Cancer & Research Institute Delhi and Oswal Hospital Ludhiana and worked in Guru Nanak Mission Charitable Hospital Jalandhar for three years.
With excellent results in all his surgeries especially Laser/ Coablation and Microdebrider assisted FESS and Adenotonsillectomies and Reverse Stapedotomy ,he has garnered a reputation for being one of the best ENT Surgeons in Northern India.He has also attended a number of National & International conferences and also conducted live surgical workshops along with the best surgeons in the field of ENT at Kataria Eye & ENT Hospital Pvt. Ltd.
The Hospital has had the pleasure of having him for more than 20 years. He has been the driving force behind the total renovation and technical advancement of the hospital which is functioning since 1977.