Can you get cysts inside your ear?

Brent Wilkerson, MD

Neurotology, Otolaryngology

It is possible to develop cysts inside your ear, including a common type of cyst known as a cholesteatoma. Cysts inside your ear can cause all kinds of ongoing problems and concerns, so it’s important to get them treated quickly. Brent Wilkerson, MD, explained how these cysts are diagnosed, treated and what you need to know.

What causes a cyst inside the ear to form?

“Cysts in the ear, or cholesteatomas, are rare, but they do sometimes occur after repeated infections, trauma or previous surgery in the ear,” said Brent Wilkerson, MD. “Normally the middle ear has skin similar to the inside of your nose, but scar tissue or eustachian tube dysfunction can gradually cause a cyst.”

Eustachian tubes, the part of the middle ear that helps equalize pressure, sometimes don’t work as well as they should. In these cases, negative pressure builds up and pulls part of the eardrum inward, creating a pocket that fills with skin cells or other material, called a cyst.  The precise cause of cholesteatoma is not always clear but factors such as infections, history of eardrum perforation or previous ear surgery may contribute to their formation.

What are the symptoms of cholesteatoma? Can cysts inside your ear cause hearing loss?

Once a cyst has formed, the material within it is trapped and can slowly enlarge. Over time, the cyst can begin to damage the surrounding parts of the ear, like the hearing bones, leading to infections.

Symptoms of cysts in the ear include infections, persistent foul smelling discharge from the ear, dizziness, tinnitus (ringing in the ear), sensation of fullness or pressure in the ear, facial weakness or paralysis, hearing loss and in some cases even total hearing loss on the same side as the cyst.

How are cysts in your ear diagnosed?

“In most cases, these cysts can be seen using a physical examination of the ear right in the doctor’s office,” said Brent Wilkerson, MD. “In someone who has had prior surgery in the ear, however, it can be a little more difficult to tell just through a visual inspection.”

A CT or MRI may be helpful in getting a more detailed and specific look into the area if there is existing scar tissue. Even if a visual examination reveals a potential cyst, a CT scan may still be used to help see the extent of the cyst in order to figure out the best treatment options.

How do you treat cysts inside your ear?

“Generally, these cysts need to be treated using surgery,” said Brent Wilkerson. “What kind of surgery and how extensive it is depends on the cyst itself.”

The surgeons will usually remove the cyst from the middle ear. Sometimes the bone just behind the ear, known as the mastoid, needs removed as well. Your surgeon will work to restore the normal internal ear anatomy as much as possible to return your hearing.

Sometimes this kind of surgery is done in stages to ensure the cyst has been completely removed so that the reconstructive surgery is more effective.

If fixing the middle ear anatomy can’t be done, because the extent of the cyst or the damage it has done to the ear anatomy is too extensive, your surgeon may need to open the mastoid into the ear canal. This kind of surgery opens up the area so that the cyst is no longer growing or trapped and won’t cause the same kind of dizziness or discomfort. While this does increase the size of the ear opening, the outside of your ear would be unchanged and there wouldn’t be any effects on the overall outside appearance.

Loss of hearing can affect your life at every level, and it’s essential to make sure a cyst is taken care of so that you can get your hearing back and have a better quality of life.