What is cholesteatoma otitis media? How does a cholesteatoma form? The middle ear cavity is the mucous membrane and the outer ear canal and outer side of the tympanic membrane is the skin. Cholesteatoma otitis media is the result of epithelial tissue entering the middle ear cavity, i.e. the skin runs into the wrong place. There are two main causes of cholesteatoma, one is the pouch invagination theory, in which due to poor ventilation of the eustachian tube, the loose part of the tympanic membrane invaginates, forming an invaginated pouch where the epithelium accumulates and forms a cholesteatoma; the other is the epithelial migration theory, in which a large perforation of the tympanic membrane causes the skin of the external ear canal to enter the middle ear and form a cholesteatoma. Therefore, both chronic dysphagia and large tympanic membrane perforations can lead to cholesteatoma formation. What are the risks of middle ear cholesteatoma? Cholesteatoma is a benign lesion, but grows in a bad way and can damage the surrounding bone, leading to hearing loss, vertigo, facial paralysis and intracranial and extracranial complications that can even be life-threatening. What causes middle ear cholesteatoma? Chronic malfunction of the eustachian tube and large perforations of the eardrum are causes of cholesteatoma, as well as chronic inflammatory irritation. What are the signs of cholesteatoma otitis media? Pus flowing from the ear, pea-like discharge, hearing loss, vertigo, facial palsy or intracranial and extracranial complications in the late stage. In what cases of cholesteatoma otitis media should surgery be performed? In principle, surgery should be performed as soon as the cholesteatoma is detected, and the earlier the surgery, the better the results. Which type of surgery should I choose for cholesteatoma otitis media? The goals of surgery are, in order, 1) to remove the lesion, 2) to obtain a dry ear, and 3) to reconstruct hearing if possible. Can cholesteatoma recur after surgery for cholesteatoma type otitis media? Cholesteatoma surgery is not a simple procedure and the recurrence rate is relatively low under an experienced ear microsurgeon. However, it is important to note that the complete bypass surgery is more effective in preserving hearing, but has a certain recurrence rate; for patients with high hearing requirements, the second stage surgery may be more effective.