Surgery should be performed as early as possible after diagnosis of cholesteatoma of the middle ear. Principles of surgical treatment: completely remove the cholesteatoma and other granulomatous and inflammatory lesions; make efforts to preserve and improve the auditory function; and try to maintain the physiological structure and function of the external auditory canal. After surgery, you can get dry ear, maintain or improve hearing, and resume normal daily life, such as you can take a bath, swim, etc., and you don’t have to go to the hospital frequently to deal with the surgical cavity. Although cholesteatoma of the middle ear is an absolute indication for surgery, it should be operated on an elective basis, except for combined intracranial and extracranial complications that require emergency surgery. Outpatient local treatment and therapy within 1 to 2 weeks before surgery, microscopic suctioning of epithelial clumps and clamping of granulation tissue at the invaginated pouch, and adequate drainage can effectively control local inflammation, which can reduce the difficulty of the surgery and help to improve the efficacy. Efforts to preserve and improve hearing are the basic requirements of tympanoplasty. If the hearing of the contralateral ear is normal or stabilized at a practical hearing level, it is possible to actively seek to improve hearing while removing the lesion. Surgery on both ears is usually performed on the worse hearing side first; the operated ear is the better hearing ear, especially if the contralateral side is totally deaf, which is more important to protect the existing hearing. If you have a cholesteatoma of the middle ear, it is recommended that you seek medical attention and follow your doctor’s instructions.