Surgery is the definitive treatment for cholesteatoma, but it is not always appropriate. In elderly patients, or in those carrying serious health problems that make operative intervention high-risk, a conservative non-surgical approach is the accepted standard of care.
This protocol is designed for cholesteatoma in elderly patients and in those whose comorbidities make surgery unsafe. It also applies when the affected ear is the patient's only hearing ear — a situation where the risk to residual hearing tips the balance firmly toward conservative management.
The approach centres on controlling disease progression through periodic removal of accumulated dead skin from within the cyst, carried out by an ear, nose and throat specialist. This is a specialist-led procedure requiring appropriate magnification.
The complete structured regimen — including surveillance intervals, decision thresholds, and follow-up criteria — is available in the full protocol below.
Treatment is appropriate for cholesteatomas in the elderly or in those with serious health problems for whom surgery would be risky.
Cholesteatoma in the only hearing ear is often treated conservatively.
Occasionally a cholesteatoma is managed conservatively by the regular removal of dead skin within the cyst to control its progression.
Skin removal is performed using an operating microscope by an ear, nose and throat surgeon.
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