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What is a cholesteatoma, and why does it need to be treated?

Kimberley Bradshaw - Head of Marketing
Written By:
Kimberley Bradshaw

Head of Online Medical Content

Paul Harrison - Audiology Expert at Hearing Aid UK
Audiologically Reviewed By:
Paul Harrison

Audiology Expert

Updated: 15th January 2026
Updated and medically reviewed: 15th January 2026 in: Hearing Loss Awareness
What is a cholesteatoma?

What is cholesteatoma, and why does it need to be treated?

When an ear infection turns into something else

 

Overview    |    What is a cholesteatoma?    |    Signs to look out for   |    Why it matters for your ears    |    Conclusion 

 

Last Hearing Aid UK Update:  25

Overview

If you've had ear discharge, hearing loss, or a feeling of fullness in one ear that won't go away, you may have come across the word "cholesteatoma".

Cholesteatoma is a strange word for an abnormal skin growth in the middle ear, and it is something that needs to be treated as soon as possible. Spotting the signs early can make a big difference in how well you hear.

Cholesteatoma is not a tumour or cancer, but it does need to be treated by a doctor because it won't go away on its own and can cause serious problems if it isn't.

 

What is a cholesteatoma?

Cholesteatoma is a bunch of skin cells that grow in the wrong place, specifically in your middle ear behind the eardrum, which is not where skin should be at all.

It's like a cyst, and the skin cells build up and form a ball of old skin that keeps getting bigger. As it does, it can hurt the fragile parts of your middle ear.

There are two kinds. Congenital cholesteatoma is uncommon and exists at birth, although it may not lead to issues until later. Acquired cholesteatoma is much more common and usually happens when someone has a lot of ear infections, long-term problems with the middle ear, or sometimes after a perforated eardrum that hasn't healed properly.

The middle ear should be an empty space filled with air. However, if it gets inflamed or infected all the time, the eardrum can become weak and pull in, forming a pocket where skin cells can grow and collect.

 

Signs to look out for

The hard part about cholesteatoma is that it can start off very slowly. You might see:

  • A constant discharge from one ear that often smells bad is one of the most obvious signs. This happens because the cholesteatoma can get infected. This isn't the kind of ear discharge that goes away after a week or two with a simple infection; it keeps coming back.
  • Hearing loss in one ear that gets worse over time. As the cholesteatoma grows, it hurts the small bones in your middle ear that send sound to your brain, which makes your hearing worse.

This kind of hearing loss doesn't affect both ears equally or happen because of getting older. It's only on one side and usually comes with other symptoms.

  • You may feel full or pressure in the affected ear, like when you're on a plane, and your ears won't pop. But this feeling doesn't go away when you swallow or yawn.
  • In more advanced cases, some people also feel dizzy, have trouble keeping their balance, or have weak facial muscles on the side that is affected. 

If you have any of these symptoms, especially if you have a persistent smelly discharge and hearing loss in one ear, you should get checked out instead of just assuming it's another ear infection.

 

Why it matters for your ears

Cholesteatoma doesn't just make it hard for you to hear; it also actively damages the parts of your ear that let you hear. The growth can wear down the ossicles, which are the tiny bones in your middle ear that carry sound from your eardrum to your inner ear.

Even after the cholesteatoma is taken out, that kind of hearing loss usually can't be fully fixed once these bones are hurt. That's why getting treatment early is so important.

Cholesteatoma can cause more serious problems if it isn't treated, in addition to hearing loss. In severe cases, it can spread to nearby areas and cause infections in the brain or inner ear. If you don't do anything about it, it won't go away; it will just get worse and cause more damage.

 

Getting a diagnosis

If you're worried about cholesteatoma, the first thing you should do is see a doctor who can look inside your ear canal and at your eardrum. Your GP can do a first checkup, but they'll usually send you to an ear, nose, and throat (ENT) specialist for a final diagnosis.

The ENT doctor will look closely at your ear with an otoscope or microscope. During this exam, they will usually be able to see the cholesteatoma or signs of it. They might also set up a CT scan to see how big the growth is and if it has affected nearby structures.

hearing test will show what kind of hearing loss you have and how bad it is. This will help you plan your treatment and find conductive hearing loss patterns that are typical of cholesteatoma. 

 

Choices for treatment

Most of the time, surgery is the only way to treat cholesteatoma because the growth needs to be physically removed. Antibiotics or ear drops won't make it go away, but they might be used to stop any infection before surgery.

It involves taking out the cholesteatoma and any damaged tissue, then rebuilding the eardrum and, if possible, the tiny bones of the middle ear to keep or restore hearing.

The size and location of the cholesteatoma will determine which type of surgery is best, but modern methods work very well. Cholesteatomas can come back, so some people need a second surgery to make sure everything has been taken out.

After treatment, it's important to check in regularly to make sure the cholesteatoma hasn't come back and to keep an eye on your hearing. Hearing aids may help if you have lost your hearing because of the cholesteatoma and your ear has healed from surgery.

Our audiologists work with ENT doctors all the time, so they can help you through the post-treatment phase, including finding the right hearing aid if you need one. 

 

Conclusion

One of those conditions that is much better dealt with sooner rather than later is cholesteatoma. If you have been having persistent ear discharge, especially if it smells bad, and you are also losing hearing in one ear, don't just brush it off as another infection.

The surgery to get rid of cholesteatoma is usually simple and has good results if the problem is found early. However, the longer you wait, the more damage it can do to your hearing and the structures around it.

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Written by Kimberley Bradshaw

Meet Kimberley Bradshaw, Head of Online Medical Content

Kimberley Bradshaw started her love of content creation, as a freelancer for many well-established medical brands.  She has written about hearing healthcare for several UK and US online health and wellness publications since.  Connect with Kimberley on LinkedIn.

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FAQs

What is the best hearing aid model for me?

In general, any audiologist will always recommend to you the hearing aid model that best suits your needs. Here is a useful checklist to make sure that is the case.

  • Audiologist's level of knowledge: The audiologist you have seen will hopefully have a wide knowledge of all available hearing aids; however, some will only be familiar with a small number of brands and, therefore, may not really be in a position to know which model is the best for you. It is OK to challenge their recommendation and ask them to justify why this particular brand is the one for you.
  • Do research: Read about the hearing aid that was recommended. Does it seem like it will suit your lifestyle? Does it have more or fewer features than you need? 
  • Be aware of sales targets: Many high street retailers have specific tie-ins to a particular manufacturer/brand. The hearing aid they have suggested may still be the correct one for you, but do your research so that you know why they might have recommended it.
Do I need one hearing aid or two?

If you have significant hearing loss in both ears, you should be wearing two hearing aids. Here are the audiological reasons why:

Localisation: The brain decodes information from both ears and compares and contrasts them. By analysing the minuscule time delays as well as the difference in the loudness of each sound reaching the ears, the person is able to accurately locate a sound source. 

Simply put, if you have better hearing on one side than the other, you can't accurately tell what direction sounds are coming from.

Less amplification is required: A phenomenon known as “binaural summation” means that the hearing aids can be set at a lower and more natural volume setting than if you wore only one hearing aid.

Head shadow effect: High frequencies, the part of your hearing that gives clarity and meaning to speech sounds, cannot bend around your head. Only low frequencies can. Therefore, if someone is talking on your unaided side, you are likely to hear that they are speaking, but be unable to tell what they have said.

Noise reduction: The brain has its own built-in noise reduction, which is only really effective when it is receiving information from both ears. If only one ear is aided, even with the best hearing aid in the world, it will be difficult for you to hear in background noise as your brain is trying to retain all of the sounds (including background noise) rather than filtering them out.

Sound quality: We are designed to hear in stereo. Only hearing from one side sounds a lot less natural to us.

Fancy some further reading on this topic?  You can read about why two hearing aids are better than one in our article, hearing aids for Both Ears, here

What are the benefits of rechargeable hearing aids?

For most people, the main benefit of a rechargeable hearing aid is simple convenience. We are used to plugging in our phones and other devices overnight for them to charge up.  Here are some other pros and cons:

For anybody with poor dexterity or issues with their fingers, having a rechargeable aid makes a huge difference, as normal hearing aid batteries are quite small and some people find them fiddly to change.

One downside is that if you forget to charge your hearing aid, then it is a problem that can't be instantly fixed. For most, a 30-minute charge will get you at least two or three hours of hearing, but if you are the type of person who is likely to forget to plug them in regularly, then you're probably better off with standard batteries.

Rechargeable aids are also a little bit bigger and are only available in Behind-the-Ear models.

Finally, just like with a mobile phone, the amount of charge you get on day one is not going to be the same as you get a few years down the line. Be sure to ask what the policy is with the manufacturer's warranty when it comes to replacing the battery.

Are Behind-the-Ear hearing aids better than In-the-Ear hearing aids?

For most people, the answer is yes. But it's never that simple.

The majority of hearing problems affect the high frequencies a lot more than the low ones. Therefore, open fitting hearing aids sound a lot more natural and ones that block your ears up can make your own voice sound like you are talking with your head in a bucket. Therefore, in-ear aids tend to be less natural.

However, the true answer is we can't tell until we have had a look in your ears to assess the size of your ear canal, and until we have tested your hearing to see which frequencies are being affected.

People with wider ear canals tend to have more flexibility, also there are open fitting modular CIC hearing aids now that do not block your ears.

There is also the age-old rule to consider, that a hearing aid will not help you if it's sat in the drawer gathering dust. If the only hearing aid you would be happy wearing is one that people can't see, then that's what you should get.

Most people can adapt to any type of hearing aid, as long as they know what to expect. Have an honest conversation with your audiologist as to what your needs are.

What are channels, and how many do I need?

Generally speaking, six or more. Unless it's none at all.  The number of channels a hearing aid has is often a simplistic way an audiologist will use to explain why one hearing aid is better than another, but channels are complex, and it is really not that straightforward.  Here are some reasons why:

Hearing aids amplify sounds of different frequencies by different amounts. Most people have lost more high frequencies than low, and therefore need more amplification in the high frequencies. The range of sounds you hear is split into frequency bands or channels, and the hearing aids are set to provide the right amount of hearing at each frequency level.

Less than six channels, and this cannot be done with much accuracy, so six is the magic number. However, a six-channel aid is typically very basic with few other features and is suitable only for hearing a single speaker in a quiet room. The number of channels is not what you should be looking at; it's more the rest of the technology that comes with them.

As a final note, different manufacturers have different approaches. One method is not necessarily better than any other. For example, some manufacturers have as many as 64 channels in their top aids. Most tend to have between 17 and 20. One manufacturer has no channels at all.

What's covered in a manufacturer's warranty?​

Manufacturer's warranties typically last between 2-5 years, depending on the brand and model, and cover defects in materials and workmanship. This includes repairs for component failures, electronic malfunctions, and manufacturing defects, but excludes damage from misuse, accidents, or normal wear. Most manufacturers also include loss and damage insurance for the first year.

We handle all warranty claims on your behalf, liaising with manufacturers and ensuring you get replacement devices quickly when needed. This comprehensive warranty coverage, combined with our lifetime aftercare, gives you complete peace of mind.

How much does the hearing test cost?

Our hearing tests are completely free, whether at our clinics or in your home. Unlike other providers who charge £30-£100 for home visits, we believe hearing healthcare should be accessible without financial barriers. Our comprehensive assessments include examination by a registered audiologist, audiogram results, and personalised recommendations.

All testing, future adjustments, and ongoing support are included at no extra cost. While NHS tests are also free, typical 6-week waiting periods often lead people to seek immediate private testing. We provide prompt, professional assessments that fit your schedule and budget.

Do you offer home visits, and are they included in the price?

Yes, we offer completely free home visits throughout the UK, and this service is included in our prices with no additional charges. Home visits are particularly valuable for people with mobility issues, busy schedules, or those who simply prefer the comfort and convenience of their own environment.

Our audiologists can conduct full hearing tests, fit hearing aids, and provide ongoing support in your home.  This service sets us apart from many providers who either don't offer home visits or charge extra for them.

Why are your hearing aids cheaper than what I'd pay on the high street?

We can offer prices up to 40% lower than high street retailers because of our business model. As a network of 200+ independent audiologists, we don't have the massive overheads of large retail chains - no expensive high street premises, no sales targets pushing audiologists to sell the most expensive options, and no costly marketing campaigns.

However, we maintain the same buying power as the big chains because we purchase on behalf of our entire nationwide network. This means you get access to the same premium hearing aids with professional service, but at genuinely competitive prices.

How long do I have to try the hearing aids before committing to keep them?

We offer a comprehensive 60-day money-back guarantee, which gives you twice the industry standard time to properly assess whether your hearing aids are right for you. This extended period recognises that adjusting to hearing aids takes time, and your brain needs several weeks to adapt to the amplified sounds.

Unlike many providers who offer just 30 days, we believe 60 days gives you the confidence to test your hearing aids in all the situations that matter to you - from quiet conversations at home to busy restaurants and outdoor activities.

Other pages you might find useful

Audiology Home Visits - For free in the UK
View Audiology Home Visits - For free in the UK
Best hearing aids available in the UK for 2026
View Best hearing aids available in the UK for 2026
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