Ear Cysts (Cholesteatoma and Preauricular Cyst)

Skin Trap: The Sealed Drain That Backs Up

Imagine your ear canal is like a sink drain—normally dead skin cells (like soap scum) wash out toward the opening on their own. In a cholesteatoma, the eardrum gets sucked inward by negative pressure, creating a pocket that traps skin inside the middle ear, like a clogged pipe folding backward and trapping debris in a sealed chamber behind the wall. That trapped skin keeps shedding (just as normal skin always does), but now the dead cells pile up in a closed space where bacteria move in like mold in a wet, dark closet. The bacteria and your own white blood cells release enzymes to fight the infection, but those enzymes are like drain cleaner—they dissolve not just the "clog" but also the bone walls around it, eating holes in the structure itself. A preauricular cyst is like a tiny sealed pouch that formed during construction of your face and never got sealed shut; skin inside keeps shedding into it, and if bacteria sneak in through the opening, the pouch fills with pus like an infected abscess.