Ear Cysts (Cholesteatoma) Average Cost

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Average Cost


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What is Ear Cysts (Cholesteatoma)?

Ear infections or otitis can affect any part of the ear. Most infections are of the outer ear (otitis extera), but sometimes bacteria can spread to the middle part of the ear (otitis media), especially if the ear drum is damaged or ruptured. Cholesteatoma is a rare condition that can with occur otitis media. It is a cyst or growth that forms around the eardrum (tympanic membrane) and extends into the bony cavity of the middle ear (the tympanic bulla). It usually occurs in dogs with chronic or recurring ear infections. Cholesteatoma is made up of epithelium cells, the cells that normally line the ear canal.  In this case, the cells have become infected, causing them to build up in several layers and secrete the protein keratin.  This is not considered a cancerous growth, but cholesteatoma do expand over time. They can put pressure on the surrounding bones and tissues and sometimes may even spread to the inner ear or the lining of the brain. Dogs with severe cases have neural ticks in the face and eyes, as well as difficulty opening their mouths or swallowing. Surgery is the best option, but in about 50% of cases the cholesteatoma returns because all of the infected material was not removed. Imaging techniques like CT scans and MRI have made cholesteatoma more detectable in the early stages when it is easier to remove effectively.

Chronic ear infection in dogs can lead to the development of an abnormal growth or cyst in the middle part of the ear. Veterinarians called this condition cholesteatoma. This is a rare condition in dogs. It is not cancerous, but the infected material will spread and can cause problems if it is not removed with surgery.


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Symptoms of Ear Cysts (Cholesteatoma) in Dogs

Early symptoms look like a typical ear infection with pain and irritation of the ear. Neural symptoms develop later. Take your dog to the veterinarian if you notice any of the following signs:

  • Head shaking
  • Pawing at ear
  • Rubbing ear on the ground
  • Tilting or rotating head towards the affected side
  • Facial paralysis
  • Drooping eyelid or constricted pupil on the affected side
  • Nystagmus (involuntary eye movements)
  • Circling
  • Lack of coordination
  • Loss of balance
  • Inability to open mouth
  • Reluctance to eat
  • Dysphagia (inability to swallow)


This is a rare condition in dogs which is only beginning to be routinely diagnosed. Some cholesteatoma have formed into hard lesions, while others are a spongy keratinous fluid filling the tympanic bulla. Various types of bacteria are present, many of which have become resistant to antibiotics.

Causes of Ear Cysts (Cholesteatoma) in Dogs

Cholesteatoma is generally associated with ear infections, but it may also occur after recent surgery. These are some of the causes that have been noted.

  • Chronic or recurrent ear infections (otitis)
  • Rupture of the eardrum
  • Eardrum bulging into the inner ear
  • Prior surgery
  • Congenital abnormality
  • More common in males
  • More likelihood of recurrence in brachycephalic breeds (breeds with very short noses such as pugs and bulldogs) due to the increased difficulty with cleaning out the ear canal.

Diagnosis of Ear Cysts (Cholesteatoma) in Dogs

The veterinarian will be able to see that your dog has an ear infection on a physical examination. Sometimes anesthesia or sedation can be necessary to make a complete examination, especially if the ear is painful. If your dog has a history of chronic or recurrent ear infections that do not respond well to antibiotics, a CT scan or an MRI will likely be taken of your dog’s ear. This would also require sedation or anesthesia. Contrast dyes can sometimes be used to make the abnormal growth more visible. Nasopharyngeal endoscopy may be necessary to obtain biopsies of the tissue inside the middle ear. The cells will be analyzed at a microscopic level and tested for bacteria.

The veterinarian will want to know your dog’s medical history, especially any prior ear infections. A detailed description of the symptoms will help to determine the severity of the problem.

Treatment of Ear Cysts (Cholesteatoma) in Dogs

Surgery is the recommended treatment for cholesteatoma. The surgery is usually a total ear canal ablation (TECLA) and/or lateral bulla osteotomy (LBO.) The veterinarian will attempt to clear all the infected material out of the ear canal and the tympanic bulla. This is minor surgery, although it can be tricky due to the shape of the ear. In some cases, several surgeries may be necessary as well as continued treatment with antibiotics. Dogs with difficulty opening their mouth or swallowing generally have more severe cases which are likely to recur.

In some cases surgery is not an option, either because the condition has already progressed too far or the dog is not healthy enough for surgery. In this case, the symptoms will usually get progressively worse and the dog will eventually have to be euthanized.

Recovery of Ear Cysts (Cholesteatoma) in Dogs

Dogs who are treated early for mild cholesteatoma are much more likely to make a full recovery. Dogs with very severe symptoms may respond initially to surgery, but the condition will often return within 6-12 months. In this case, it could be difficult to fully eliminate the problem and a long term treatment plan would need to be discussed with the veterinarian. Regular check-ups and prompt treatment for any signs of ear infection are recommended in order to prevent the development of cholesteatoma.

Ear Cysts (Cholesteatoma) Questions and Advice from Veterinary Professionals

Long-Haired Chihuahua
7 Years
Moderate condition
0 found helpful
Moderate condition

Has Symptoms

No symptoms at all.

My Chihuahua has a lump behind his right ear (near the fold). I thought something might have bitten him because it was really red when I first noticed it. I began to place an antibiotic cream on the lump. The redness has went away but the lump is the same size, which is around the size of a jellybean except it's round, not oval in shape. He is not scratching at it nor shaking his head. He doesn't act as though it even bothers him when I put the antibiotic cream on it either.

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3318 Recommendations
Without examining Peanut I cannot say whether this is a cyst, reaction to a bite, haematoma or due to another cause; if it isn’t causing any distress, keep an eye on it for the next week. However, if it doesn’t go down, it gets bigger, ruptures or anything else concerning you should visit your Veterinarian for an examination. Regards Dr Callum Turner DVM

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14 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms


We have a beagle and he is 14.5 years old. We had the surgery to get rid of the ear cyst 2 years ago but it has returned. His ear now smells pretty bad from the discharge of the cyst when he scratches it. He has been treated numerous times throughout the year for an ear infection in that same year. My question is what are the options if the cyst bursts (like I said before we opted for the surgery 2 years ago but as much as we love him, he is almost 15 years old. Plus, after paying $700 the cyst came back)? I hate that he may be in pain and am wondering if the next step is to put him down to put him out of his misery.

Dr. Michele King, DVM
Dr. Michele King, DVM
1608 Recommendations
Cysts in the ears can be difficult to get rid of, as it is a tight spot to do surgery in, and if even a small piece of the cyst remains after removal, it may grow back. The ear infections that Lucky is getting are probably related to the cyst being there, more than any discharge from the cyst. Those cysts don't typically burst, but do often continue to grow and cause chronic ear infections and pain. At 15 years old, you may elect to treat him for the infection on an ongoing basis rather than opt for removal of the cyst again, but since I can't see him, that would be a great question to ask your veterinarian, since they know his history and can examine him and look at his ear.

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Pit bull
1 Year
Serious condition
1 found helpful
Serious condition

Has Symptoms

Head Shaking, Ear scratching
Head Shaking

Is there any other option besides surgery for you dog? My dog has had a chronic ear infection for a while now and now he has a small cyst, is there something we can do for him until we can afford surgery

Dr. Callum Turner, DVM
Dr. Callum Turner, DVM
3318 Recommendations
With chronic ear infections, all you can do is to regularly clean the ears and apply drops as directed by your Veterinarian; in cases chronic ear infection, surgery on the ear canal to either open it up or ablation is a recommended course of action. The cheapest price for lateral ear canal resection I’ve found is around $700 which may be cost prohibitive. Regards Dr Callum Turner DVM

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Labrador Retriever
4 Years
Serious condition
0 found helpful
Serious condition

Has Symptoms

Head Shaking

My lab dx last eve with middle ear infection and ruptured membrane. With each breath there is air flow coming out of the ear. The vet is very puzzled. He did scope in mouth and ear and didn't see anything. Did say couldn't see very well in middle ear- with infection present.

Dr. Michele King, DVM
Dr. Michele King, DVM
1608 Recommendations
Thank you for your email If Decoy has a ruputred ear drum and infection in his middle ear, those are typically treated with antibiotics and topical medications that are safe for the middle ear. Ear drums can heal, but typically take quite a while to do so, so treatment would need to be continued until it has healed. Your veterinarian should be able to get appropriate medications for you to treat him. I hope that all goes well for him.

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