Guinea Pig Aural Cholesteatoma (Ear Cyst): Vet Guide 2025 🐹🩺

— Written by Dr Duncan Houston BVSc, founder of Ask A Vet —

1. Introduction

Aural cholesteatoma—also called tympanokeratoma—is a rare but serious condition in guinea pigs. This benign yet aggressive growth comprises keratin-filled cystic tissue in the middle ear and mastoid region. Without intervention, it can erode bone, damage inner structures, and lead to hearing loss, infection, and neurological signs.

2. What Is an Aural Cholesteatoma?

This condition involves abnormal accumulation of keratinizing epithelial cells in the middle ear, forming expanding masses that can resorb bone and invade ear structures—even the inner ear :contentReference[oaicite:2]{index=2}.

3. How Does It Develop?

• Chronic ear infections: Ongoing otitis media or interna causes eustachian dysfunction and keratin accumulation in the middle ear :contentReference[oaicite:3]{index=3}.
• Congenital link: Less evidence in guinea pigs, but gerbil models suggest hereditary predisposition :contentReference[oaicite:4]{index=4}.

4. Common Signs & Symptoms

• Persistent ear discharge—often foul-smelling
• Head tilt, circling, balance issues
• Hearing loss, reduced response to noise
• Facial nerve paralysis—e.g., ear droop, corneal dysfunction
• Occasional sneezing or nasal discharge

Signs may resemble routine ear infections but with chronic progression despite treatment :contentReference[oaicite:5]{index=5}.

5. Diagnosing the Condition

• Clinical exam: Otoscopic or microscopic evaluation reveals debris, discharge, and canal obstruction.
• Imaging: Skull radiographs, CT, or MRI to detect bony erosion and the extent of middle ear mass.
• Sampling: Cytology and culture to rule out bacterial or fungal co-infections.
• Definitive diagnosis: Histopathology of surgical excision confirms keratin-filled cyst of cholesteatoma.

6. Treatment Options

Surgery

• Total ear canal ablation with bulla osteotomy (TECA–BO): Surgical removal of the canal and infected bulla.
• Debridement: Removal of keratin debris; although helpful, less effective long-term.
• Recurrence risk: Relapse is common if not fully excised :contentReference[oaicite:6]{index=6}.

Medical Management

• Long-term antibiotics targeting chronic otitis media pathogens
• Topical ear cleaners with anti-inflammatory or antiseptic properties
• Corticosteroids to reduce inflammation and edema
• Supportive care: pain relief (NSAIDs), hydration, and high-dose vitamin A where appropriate

7. Home & Post-op Care

• Keep ear clean and dry—avoid water ingress
• Administer medications based on vet instructions
• Monitor for worsening signs—head tilt, discharge, facial paralysis
• Provide quiet, low-stress environment to aid recovery
• Schedule regular follow-ups with vet for rechecks and imaging if needed

8. Prognosis & Complications

• Good prognosis: With thorough surgical removal and no neurological signs
• Guarded prognosis: If inner ear or nerves are involved
• Complications: Recurrence, permanent hearing loss, facial nerve damage, balance issues

9. Prevention & Monitoring

• Early treatment of ear infections—don’t ignore mild signs like itching or sneezing :contentReference[oaicite:7]{index=7}.
• Routine ear cleaning with veterinary-approved solutions
• Monitor older pigs for subtle ear issues and schedule ear exams
• Quarantine and treat new arrivals to avoid introducing ear pathogens

10. Ask A Vet Support

• 📞 Remote triage to assess ear condition and urgency
• 📸 Help interpreting photos or videos of discharge, head tilt, or facial changes
• 💊 Guidance on cleaning routines, antibiotic protocols, and anti-inflammatories
• 🔔 Post-op reminders—medicine schedule, follow-up imaging, and monitoring
• 🧭 Referral advice to the best local exotic vet with surgical expertise

11. Summary Table

📣 Conclusion

Aural cholesteatoma in guinea pigs is a serious ear disease requiring surgical intervention and expert care. Early detection, consistent vet check-ups, and diligent at-home management provide the best chances for recovery. With Ask A Vet's support—from triage to post-op—your guinea pig can face the best possible outcome and restore quality of life.

Noticed ear discharge, head tilt, or odd head carriage? Contact your exotic vet promptly and upload images via the Ask A Vet app for fast support. 📱

— Dr Duncan Houston BVSc, Ask A Vet