Cholesteatoma otitis media is not really a tumor as it is usually called, but rather a cystic structure located in the middle ear and mastoid cavity. The inner wall of the capsule is a compound squamous epithelium filled with exfoliated epithelium, keratinized material and cholesterol crystals, and the outer side of the capsule is closely connected to its adjacent bone wall or tissue by a layer of fibrous tissue of varying thickness. It is called cholesteatoma because of the presence of cholesterol crystals in the cyst. Cholesteatoma is characterized by a persistent pus flow from the ear, a peculiar foul odor, and a marginal perforation in the posterior and superior parts of the relaxed or tense tympanic membrane. The perforation is visible as a grayish-white scaly or pea-like substance in the tympanic chamber, which is foul-smelling. CT examination can determine the extent of the lesion and guide surgery. The exact mechanism of cholesteatoma formation is not known, but the direct pressure of the cholesteatoma or the release of chemicals can destroy the surrounding bone and spread the inflammation, leading to a series of intracranial and extracranial complications. Therefore, “cholesteatoma of the middle ear must be treated with surgery as soon as possible”. The principle of treatment for cholesteatoma middle ear is to perform early modified mastoid radical surgery or mastoid radical surgery to completely remove the lesion, prevent complications, and obtain a dry ear, and perform tympanoplasty to improve hearing as appropriate.