Xiao Zhang has had pus flowing from his ear canal for several years, and it comes and goes. At the beginning of the year, the disease recurred, and the pus flowed with blood, and symptoms such as high fever, headache and drowsiness appeared. Accompanied by his family, he immediately went to a specialist hospital for treatment. After examination by a physician, he was diagnosed with cholesteatoma otitis media complicated by meningitis. He was treated with antibacterial medication and underwent mastoidectomy and tympanoplasty to achieve recovery. Medically, otitis media can be divided into “simple” and “cholesteatoma” types according to their different characteristics. The former is usually a perforation of the tense part of the tympanic membrane, with pus flowing like sticky snot, which is not too smelly, and the pus flowing sometimes and sometimes stopping, which will lead to hearing loss in the long term. The name cholesteatoma is very reminiscent of a tumor, but it is not really a tumor. The epithelial cells of the external ear canal grow into the middle ear cavity because the inflammation does not heal, these epithelial cells become more active, and the layers of shed skin gradually accumulate and increase in size, expanding and compressing and invading the surrounding bone, causing the bone to resorb and destroy. It is not a tumor. But cholesteatoma is not a tumor, it is an epidermal cyst. Although it is not a tumor, it destroys the surrounding bone and organs and behaves like a tumor, so it must be taken seriously. The middle ear is surrounded by the auditory sensory organs of the inner ear, balance organs, facial nerve, gustatory nerve, large blood vessels, and the brain in close proximity. Cholesteatoma of the middle ear, if not removed in time, will lead to damage of the above organs with serious consequences. In clinical practice, cholesteatoma is often compared to a “time bomb” buried in the ear, which often “explodes” with the aggravation of inflammation, resulting in serious consequences. The cholesteatoma gradually increases in size, destroys the surrounding bone, often becomes infected, and the pus does not drain easily into the outer ear canal, spreading to the surrounding crevices. If the pus in the middle ear passes through the destroyed bone and spreads to the skull base, an epidural abscess can be formed if it accumulates between the skull and the dura mater. Patients often have headache on one side, low-grade fever, and periodic large amounts of pus flowing from the ear canal. If the inflammation invades further into the skull or bacteria invade brain tissue with blood or lymphatic fluid, it may cause septic meningitis or brain abscess, etc. Symptoms such as persistent headache, jet vomiting, drowsiness, aphasia or even coma may occur; if the cholesteatoma develops behind the eardrum and penetrates the mastoid bone, it may form an abscess under the periosteum, which will be red and swollen behind the ear, pushing the eardrum forward and squeezing the eardrum to shrug up, or penetrate the If the facial nerve is invaded inward, peripheral facial palsy may occur, and the patient’s eyelids on the affected side of the ear cannot be closed and the corners of the mouth are distorted to the opposite side. Therefore, patients with chronic otitis media should promptly seek help from an otolaryngologist to see if there is a possibility of the presence of cholesteatoma. If a cholesteatoma is present, it should be surgically removed and the middle ear structure should be reconstructed in a timely manner. The facial nerve passes through the ear, and when the lesion is severe, it is not easy to identify the nerve and inflammatory granulation, and surgery should be performed to prevent the possibility of facial paralysis. Current microsurgical techniques have proven experience in dealing with cholesteatoma otitis media, and international exchanges have allowed excellent otologists in China to have world-class surgical treatment techniques. Not only can the surgery easily remove the cholesteatoma, but in most cases, hearing can be reconstructed and tinnitus treated without nerve injury.