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Cholesteatoma (Ear Cysts, Chronic Inflammation in the Middle Ear) in Dogs

Occurrence: very rare
Location of illness: Head/Neck

Author: Dr. med. vet. Gisa Löwe | Last modified: 06.11.2025

A cholesteatoma is an abnormal collection of skin cells and other materials in the middle ear, often associated with chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. inflammation, which can lead to progressiveProgressive describes a condition or disease that worsens over time. This term is often used to characterize the course of an illness that causes increasingly severe symptoms or damage. destructionDestruction means "demolition." In medicine, it refers to the destruction of cells, tissues, organs, or body parts. The growth of malignant Tumors is also usually accompanied by destruction of the surrounding tissue. of the surrounding structures.

The most important facts at a glance

A cholesteatoma in dogs is a cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause. in the middle ear that is usually caused by chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. otitis media. These inflammations can be caused by infections, allergies, or malfunctions of the Eustachian tube. The accumulating skin cells and waste materials form a cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause. that can put 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 chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infections, head shaking, scratching the ear, pain on jaw movement, and rarely balance disorders. DiagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is made by a thorough examination, otoscopyOtoscopy is an examination of the ear canal and eardrum using an otoscope. It is performed to diagnose ear conditions, such as infections or foreign bodies., and imaging procedures such as CT or MRI to assess the extent of the disease. A microbiological examination of the ear secretion can help to determine the type of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease..

Treatment often combines surgical removal of the cholesteatoma with medical approaches such as antibiotics. Aftercare is important to avoid complications. Regular veterinary check-ups are necessary to minimize the risk of recurrence. The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is usually favorable with early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and treatment, but a risk of recurrence exists.

PreventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring. focuses on avoiding chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infections through regular ear care and identification of allergies. Research aims to improve diagnostic methods and minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. surgical techniques. Genetic studies and investigations into inflammatory conditions 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 chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. otitis media. This inflammation can be triggered by bacterial or viralViral refers to viruses and their effects on the organism. Viral infections in dogs and cats can range from harmless colds to severe, life-threatening diseases. infections, allergies, or a malfunction of the Eustachian tube. This malfunction leads to negative pressure in the middle ear, causing the eardrum to retract and skin cells to enter the middle ear space.

The accumulation of skin cells and other waste materials in the middle ear forms a type of cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause. that grows over time. The cholesteatoma can put pressure on and damage the surrounding structures. If left untreated, it can lead to serious complications such as hearing loss, infections, or even neurological symptoms.

Genetic factors can 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 chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infections and, therefore, of developing a cholesteatoma.

Symptoms

Very common symptoms:

Common symptoms:

Rare symptoms:

The symptoms of a cholesteatoma in dogs can start subtly and slowly worsen. The first signs often include recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. or chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infections that do not heal completely 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 infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease. and decomposition of the dead skin cells. The dog may also frequently shake its head or scratch at its ears, indicating 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.

Diagnosis

The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of a cholesteatoma begins with a thorough clinical examination by a veterinarian. The veterinarian will carefully examine the dog’s ear and look for signs of inflammation, infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease., or other abnormalities. OtoscopyOtoscopy is an examination of the ear canal and eardrum using an otoscope. It is performed to diagnose ear conditions, such as infections or foreign bodies., in which the inside of the ear canal is viewed with a special instrument, can help identify visible signs of the cholesteatoma.

Imaging procedures such as X-rays, CT scans, or MRIs are often necessary to assess the extent of the cholesteatoma and the degree of tissue damage. These techniques allow a detailed representation of the middle ear structures and can help rule out other possible causes for the symptoms.

In addition, microbiological examinations of ear secretions can be performed to determine the type of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease. and select the appropriate antibiotic therapy. Blood tests can also be helpful to assess the dog’s general health and identify other underlying health problems.

Therapy

Treatment of a cholesteatoma usually requires a combination of medical and surgical approaches. The primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. treatment often involves surgical removal of the cholesteatoma to eliminate the source of inflammation and pressure. The surgical procedure may vary depending on the size and location of the cholesteatoma and usually requires the expertise of a specialized veterinarian or veterinary surgeon.

After surgery, careful aftercare is necessary to minimize the risk of complications or recurrence. Antibiotics and anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. are often prescribed to combat infections and promote healing. Pain medication may also be necessary 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 the dog is prone to recurrentRecurrent refers to a disease that repeatedly returns or worsens after a temporary remission or improvement. ear infections. Regular veterinary check-ups are important to monitor the healing progress and detect any complications early on.

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 presence of complications, and the dog’s general health. With early diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. and appropriate treatment, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. is usually favorable, and many dogs recover well from surgery.

However, some dogs are at risk of recurrence, especially if the cholesteatoma could not be completely removed or the underlying cause of the chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease. has not been resolved. In such cases, long-term monitoring and treatment may be necessary to minimize the risk of recurrence.

If left untreated, a cholesteatoma can lead to severe complications, including permanent hearing loss, chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. infections, or neurological problems. Therefore, early intervention is crucial for a positive prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop..

Prevention

The preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring. of a cholesteatoma in dogs focuses primarily on preventing chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. ear infections, which are often the underlying cause. Regular ear care is crucial to prevent the accumulation of dirt, wax, and moisture that can increase the risk of infections.

Owners should regularly check their dog’s ears for signs of inflammation, redness, or unpleasant odors and consult a veterinarian if necessary. Proper ear cleaning, performed with a suitable cleaning solution, can help reduce the risk of infections.

For dogs that are prone to ear problems, it can be helpful to identify and treat any potential allergies or other underlying health problems. A balanced diet and avoiding allergens can also help reduce the risk of ear infections.

Regular veterinary examinations are important to monitor the dog’s general health and detect any potential problems early on. Close collaboration with the veterinarian can help develop individual preventionPrevention includes measures taken to prevent diseases or injuries. In veterinary medicine, this includes vaccinations, parasite control, and health monitoring. strategies tailored to the dog’s specific needs.

Outlook on current research

Cholesteatomas in dogs are a rare but serious condition that affects the middle ear and often requires surgical treatment. Current research focuses on improving diagnostic methods and expanding therapeutic options. The use of imaging techniques such as computed tomography (CT)Computed tomography (CT) is an imaging technique that uses X-rays and computer technology to create cross-sectional images of the body. It enables a detailed view of bones, organs, and other structures and is used for the diagnosis of injuries, diseases, and for planning medical interventions. and magnetic resonance imaging (MRI)Magnetic resonance imaging is an imaging technique that uses strong magnetic fields and radio waves to create detailed images of the inside of the body. It is used in veterinary medicine to diagnose diseases of the brain, spine, and other organs. has shown promise in providing a more accurate representation of the extent and progressionProgression refers to the advancement or worsening of a disease over time. It describes an increase in the severity or extent of the disease symptoms. of cholesteatomas. These advanced imaging techniques offer veterinarians the ability to obtain detailed information about the location and size of the cholesteatomas, which facilitates the planning of surgical removal.

Another area of research focuses on the development of minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. surgical techniques to minimize the risks associated with traditional surgical procedures. Endoscopic methods are increasingly being explored and used to enable more precise interventions with fewer postoperativePostoperative refers to the time after a surgical operation. This phase includes recovery and the management of possible complications after the procedure. complications. These techniques can help shorten healing times and improve the quality of life of affected dogs.

The study of the genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases. to cholesteatomas in dogs is also an emerging field of research. Scientists have begun to identify genetic markers that may be associated with an increased risk of developing this condition. These findings could help to identify at-risk dogs early on and take preventive measures in the future.

In addition, the role of inflammatory conditions and infections in the development and progressionProgression refers to the advancement or worsening of a disease over time. It describes an increase in the severity or extent of the disease symptoms. of cholesteatomas is being intensively investigated. Researchers are trying to better understand the underlying mechanisms in order to develop targeted therapeutic approaches that can control the inflammatory responses and inhibit the growth of cholesteatomas.

In summary, current research is making progress on several fronts to improve the understanding, diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients., and treatment of cholesteatomas in dogs. The combination of advanced imaging, minimally invasiveInvasive describes medical procedures or pathogens that enter the body or penetrate tissue. In medicine, invasive procedures can range from minimally invasive techniques to open surgery. techniques, and genetic studies offers promising approaches to significantly improve the quality of life of affected dogs.

Frequently asked questions (FAQs)

What is a cholesteatoma in dogs? A cholesteatoma is an abnormal tissue growth in the middle ear of a dog. It is a cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause. consisting of dead skin cells and inflammatory fluid. These cysts can damage the surrounding tissue and lead to chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. infections.
How do I know if my dog has a cholesteatoma? Signs of a cholesteatoma can include ear pain, head shaking, head tilted to one side, balance disorders, and an unpleasant odor from the ear. A veterinarian can make a diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. through a thorough examination and imaging procedures.
How is a cholesteatoma diagnosed? The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. is usually made through a combination of clinical examination, otoscopyOtoscopy is an examination of the ear canal and eardrum using an otoscope. It is performed to diagnose ear conditions, such as infections or foreign bodies., and imaging procedures such as CT or MRI to determine the extent of the cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause..
What treatment options are available for cholesteatomas in dogs? The primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. treatment usually consists of surgical removal of the cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause.. In some cases, antibiotics and anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. may be used to control infections and inflammation.
Is surgery always necessary? In most cases, surgery is necessary to completely remove the cyst and avoid further complications. However, the exact treatment plan should be discussed with a veterinarian.
What is the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. for dogs with cholesteatoma? The prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. depends on the size and progressionProgression refers to the advancement or worsening of a disease over time. It describes an increase in the severity or extent of the disease symptoms. of the cystA cyst is a closed sac that may contain fluid, air, or other material. Cysts can occur in any part of the body and vary in size and cause., as well as the success of surgical removal. Cholesteatomas that are detected and treated early have a better prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop..
Can cholesteatomas be prevented? There are no specific preventive measures, but regular ear examinations and good ear hygiene can help detect early signs and reduce the risk of complications.
Are certain dog breeds more prone to cholesteatomas? Some studies suggest that certain breeds, especially those with narrow ear canals or a genetic predispositionA predisposition is an innate inclination or susceptibility of an organism to certain diseases or conditions. In dogs and cats, there may be a genetic predisposition to certain conditions such as hip dysplasia or certain heart diseases., may be at higher risk of developing cholesteatomas. However, further research is needed to confirm this.
How long does recovery take after surgery? The recovery time after surgery can vary, but is usually several weeks. During this time, follow-up appointments with the veterinarian are important to monitor the healing process.
Can cholesteatomas recur after treatment? There is a possibility that cholesteatomas may recur after treatment, especially if not all of the abnormally grown tissue has been removed. Regular follow-up examinations are important to detect any recurrence early on.