Abnormal Skin Growth in the Middle Ear in Dogs (Cholesteatoma)
- Synonyms: Pearly tumor, epidermoid cysts in the middle ear, chronic epitympanic otitis media
- Occurrence: very rare
- Location of disease: Head/Neck
When to visit the vet?
Non-urgent see a veterinarian within 2–3 days
If the condition worsens / symptoms persist, consult a veterinarian.
Definition
A cholesteatoma is an abnormal buildup of skin cells and other material in the middle ear, often associated with chronic inflammatory conditions and can lead to progressive destruction of surrounding structures.
The most important facts at a glance
A cholesteatoma in dogs is a cyst in the middle ear that usually develops due to chronic middle ear inflammation. These inflammatory conditions can be caused by infections, allergies, or dysfunction of the Eustachian tube. The accumulating skin cells and debris form a cyst that puts pressure on surrounding structures and, if left untreated, can lead to complications such as hearing loss. Certain dog breeds with long ears have a higher risk of developing a cholesteatoma.
Symptoms include chronic Ear infections, Head shaking, Scratching the ear, Pain on jaw movement, and rarely Balance disorders. The diagnosis is made through a thorough examination, an otoscopy, and imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) to assess the extent of the disease. A microbiological examination of the ear discharge can help determine the type of infection.
Treatment often combines surgical removal of the cholesteatoma with medical approaches such as antibiotics. Postoperative care is important to avoid complications. Regular veterinary check-ups are necessary to minimize the risk of recurrence / relapse. The prognosis is usually favorable with early diagnosis and treatment, but there is a risk of recurrence / relapse.
Prevention focuses on avoiding chronic Ear infections through regular ear care and identifying Allergies. Research aims to improve diagnosis methods and minimally interventional surgical techniques. Genetic studies and investigations into inflammatory processes also contribute to a better understanding and treatment.
Causes
The middle ear of dogs consists of a small, air-filled chamber separated from the external auditory canal by the eardrum. It contains three tiny ossicles that transmit sound waves from the eardrum to the inner ear. This structure is crucial for hearing function.
A cholesteatoma often develops as a result of chronic middle ear inflammation (otitis media). This inflammatory condition can be triggered by bacterial or viral infections, allergies, or dysfunction of the Eustachian tube. This dysfunction creates negative pressure in the middle ear, causing the eardrum to retract and allowing skin cells to enter the middle ear space.
The buildup of skin cells and other debris in the middle ear forms a type of cyst that grows over time. The cholesteatoma can put pressure on surrounding structures and damage them. If it progresses untreated, serious complications such as hearing loss, infections, or even neurological symptoms can occur.
Genetic factors may also play a role, as certain dog breeds are more prone to ear problems. Dogs with long, drooping ears, such as Cocker Spaniels or Basset Hounds, tend to have a higher risk of chronic ear inflammation and therefore of developing a cholesteatoma.
Symptoms
The Symptoms of a cholesteatoma in dogs can start subtly and gradually worsen. Initial signs often include recurring or chronic Ear infections that do not fully heal despite treatment. The affected ear may be red and swollen, and the dog may show signs of Pain or discomfort.
Another common symptom is an unpleasant odor from the ear, caused by the infection and decomposition of dead skin cells. The dog might also frequently exhibit Head shaking or Scratching the ear, which could indicate Itching or discomfort.
Advanced cases can lead to hearing loss, as the cholesteatoma can damage the ossicles and the eardrum. In rare cases, if the cholesteatoma penetrates the inner ear or surrounding structures, neurological symptoms such as balance disorders, head tilted to one side, or even convulsions can occur.
Therapy
Treating a cholesteatoma usually requires a combination of medical and surgical approaches. The primary treatment often involves surgical removal of the cholesteatoma to eliminate the source of inflammation and pressure. The surgical procedure can vary depending on the size and location of the cholesteatoma and typically requires the expertise of a specialized veterinarian or veterinary surgeon.
After surgery, careful postoperative care is necessary to minimize the risk of complications or recurrence / relapse. Antibiotics and anti-inflammatory medications are often prescribed to treat infections and promote healing. Pain medication may also be required to ensure the dog’s well-being during recovery.
In some cases, long-term medical treatment may be necessary, especially if the cholesteatoma could not be completely removed or if the dog is prone to recurring Ear infections. Regular veterinary check-ups are important to monitor the healing process and detect possible complications early.
Prognosis and follow-up care
The prognosis for dogs with a cholesteatoma depends on various factors, including the size and location of the cholesteatoma, the prevalence of complications, and the dog’s general health status. With early diagnosis and appropriate treatment, the prognosis is generally favorable, and many dogs recover well from surgery.
However, some dogs are at risk of recurrence / relapse, especially if the cholesteatoma could not be completely removed or if the underlying cause of the chronic ear inflammation was not addressed. In such cases, long-term monitoring and treatment may be necessary to minimize the risk of recurrence / relapse.
Untreated, a cholesteatoma can lead to serious complications, including permanent Hearing loss, chronic infections, or neurological problems. Therefore, early interventional is crucial for a positive prognosis.
Prevention
The prevention of a cholesteatoma in dogs primarily focuses on preventing chronic Ear infections, which are often the underlying cause. Regular ear care is crucial to prevent the accumulation of dirt, wax, and moisture, which can increase the risk of infection.
Owners should regularly check their dog’s ears for signs of Inflammatory conditions, redness, or unpleasant odors and consult a veterinarian if necessary. Proper ear cleaning with an appropriate cleaning solution can help reduce the risk of infection.
For dogs that are prone to ear problems, it can be helpful to identify and treat possible allergies or other underlying health issues. A balanced diet and avoiding allergens can also help reduce the risk of ear inflammation.
Regular veterinary examinations are important to monitor the dog’s general health and detect potential problems early. Close collaboration with the veterinarian can help develop individual prevention strategies tailored to the dog’s specific needs.
Outlook on current research
Cholesteatomas in dogs are a rare but serious condition affecting the middle ear, often requiring surgical treatment. Current research focuses on improving diagnosis methods and expanding therapeutic options. The use of imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) has proven promising for providing a more accurate representation of the extent and progression of cholesteatomas. These advanced imaging procedures allow veterinarians to obtain detailed information about the location and size of cholesteatomas, which facilitates the planning of surgical removal.
Another research area focuses on developing minimally interventional surgical techniques to reduce the risks of traditional procedures. Endoscopic methods are increasingly being explored and used to enable more precise interventions with fewer postoperative complications. These techniques can help shorten healing times and improve the quality of life for affected dogs.
The investigation of the genetic predisposition for cholesteatomas in dogs is also an emerging research field. Scientists have begun to identify genetic markers associated with an increased risk for developing this disease. These findings could help identify at-risk dogs early and implement preventive measures in the future.
Additionally, the role of inflammatory processes and infections in the development and progression of cholesteatomas is being intensively studied. Researchers are trying to better understand the underlying mechanisms to develop targeted therapeutic approaches that can control inflammatory reactions and inhibit the growth of cholesteatomas.
In summary, current research is making progress on multiple fronts to improve understanding, diagnosis, and treatment of cholesteatomas in dogs. The combination of advanced imaging, minimally invasive techniques, and genetic studies offers promising approaches to significantly improve the quality of life of affected dogs.
Frequently Asked Questions (FAQs)
1. What is a cholesteatoma in dogs?
2. How do I know if my dog has a cholesteatoma?
3. How is a cholesteatoma diagnosed?
4. What treatment options are available for cholesteatomas in dogs?
5. Is surgery always necessary?
6. What is the prognosis for dogs with cholesteatoma?
7. Can cholesteatomas be prevented?
8. Are certain dog breeds more susceptible to cholesteatomas?
9. How long does recovery take after surgery?
10. Can cholesteatomas recur / relapse after treatment?
Literature
- Berger, A. C., Bertran, J., Williams, R. W., & Hawkins, I. (2026). Aural cholesteatoma (tympanokeratoma) in veterinary medicine: An update and principles of clinical management. Veterinary Dermatology. Advance online publication. https://doi.org/10.1111/vde.70053
- Martin-Bernal, C., Canfrán, S., Asencio, A., & Laredo, F. G. (2026). Mid- to long-term outcomes of the surgical treatment of 20 middle ear cholesteatomas in French bulldogs. Journal of Veterinary Internal Medicine, 40(1), 449–458. https://doi.org/10.1111/jvim.70016
- Risselada, M. (2016). Diagnosis and management of cholesteatomas in dogs. Veterinary Clinics of North America: Small Animal Practice, 46(4), 623–634. https://doi.org/10.1016/j.cvsm.2016.01.002
- Imai, A., Kondo, H., Suganuma, T., & Nagata, M. (2019). Clinical analysis and nonsurgical management of 11 dogs with aural cholesteatoma. Veterinary Dermatology, 30(1), 42–e12. https://doi.org/10.1111/vde.12707
- Banco, B., Giudice, C., Di Giancamillo, M., Travetti, O., Mortellaro, C. M., & Grieco, V. (2014). Canine aural cholesteatoma: A histological and immunohistochemical study. Veterinary Journal, 200(3), 440–445. https://doi.org/10.1016/j.tvjl.2014.03.012
- Greci, V., Travetti, O., Di Giancamillo, M., Lombardo, R., Giudice, C., Banco, B., & Mortellaro, C. M. (2011). Middle ear cholesteatoma in 11 dogs. The Canadian Veterinary Journal, 52(6), 631–636.
- Hardie, E. M., Linder, K. E., & Pease, A. P. (2008). Aural cholesteatoma in twenty dogs. Veterinary Surgery, 37(8), 763–770. https://doi.org/10.1111/j.1532-950X.2008.00455.x
- Travetti, O., Giudice, C., Greci, V., Lombardo, R., Mortellaro, C. M., & Di Giancamillo, M. (2010). Computed tomography features of middle ear cholesteatoma in dogs. Veterinary Radiology & Ultrasound, 51(4), 374–379. https://doi.org/10.1111/j.1740-8261.2010.01682.x
- Berger, A. C., Bertran, J., Williams, R. W., & Hawkins, I. (2026). Aural cholesteatoma (tympanokeratoma) in veterinary medicine: An update and principles of clinical management. Veterinary Dermatology. Advance online publication. https://doi.org/10.1111/vde.70053
- Martin-Bernal, C., Canfrán, S., Asencio, A., & Laredo, F. G. (2026). Mid- to long-term outcomes of the surgical treatment of 20 middle ear cholesteatomas in French bulldogs. Journal of Veterinary Internal Medicine, 40(1), 449–458. https://doi.org/10.1111/jvim.70016
- Risselada, M. (2016). Diagnosis and management of cholesteatomas in dogs. Veterinary Clinics of North America: Small Animal Practice, 46(4), 623–634. https://doi.org/10.1016/j.cvsm.2016.01.002
- Imai, A., Kondo, H., Suganuma, T., & Nagata, M. (2019). Clinical analysis and nonsurgical management of 11 dogs with aural cholesteatoma. Veterinary Dermatology, 30(1), 42–e12. https://doi.org/10.1111/vde.12707
- Banco, B., Giudice, C., Di Giancamillo, M., Travetti, O., Mortellaro, C. M., & Grieco, V. (2014). Canine aural cholesteatoma: A histological and immunohistochemical study. Veterinary Journal, 200(3), 440–445. https://doi.org/10.1016/j.tvjl.2014.03.012
- Greci, V., Travetti, O., Di Giancamillo, M., Lombardo, R., Giudice, C., Banco, B., & Mortellaro, C. M. (2011). Middle ear cholesteatoma in 11 dogs. The Canadian Veterinary Journal, 52(6), 631–636.
- Hardie, E. M., Linder, K. E., & Pease, A. P. (2008). Aural cholesteatoma in twenty dogs. Veterinary Surgery, 37(8), 763–770. https://doi.org/10.1111/j.1532-950X.2008.00455.x
- Travetti, O., Giudice, C., Greci, V., Lombardo, R., Mortellaro, C. M., & Di Giancamillo, M. (2010). Computed tomography features of middle ear cholesteatoma in dogs. Veterinary Radiology & Ultrasound, 51(4), 374–379. https://doi.org/10.1111/j.1740-8261.2010.01682.x