The clinical manifestation of middle ear cholesteatoma is prolonged ear pus, some of which is accompanied by a foul odor.
Patients have varying degrees of hearing loss. Some patients have tinnitus, but less frequently they have ear pain and vertigo if the semicircular canal is disrupted. Patients with congenital middle ear cholesteatoma may be asymptomatic in the early stages, or may simply present with ear leakage and hearing loss.