Cholesteatoma otitis media, the standardized name of which is cholesteatoma of the middle ear, is an inflammatory disease of the middle ear, in which the degree of hearing loss is related to the degree of involvement of the auditory ossicles and the morphology of the tympanic membrane, and which can only be determined after pure tone audiometry. Middle ear cholesteatoma is a cystic structure formed by keratinized squamous epithelium in the middle ear. Those who present with conscious symptoms are similar to those with chronic suppurative otitis media, with hearing loss and ear drainage. The degree of conductive hearing loss is related to the degree of involvement of the auditory ossicle chain and whether the tympanic membrane is morphologically normal, but sometimes the auditory ossicle chain is replaced by cholesteatoma tissue and the hearing can be nearly normal. When pure tone audiometry is performed, conductive deafness is found, and if there is an interruption of the auditory ossicle chain, the air-bone conductance difference can be as high as 40 dB; combined with labyrinthitis, mixed or sensorineural deafness can occur, and high-frequency hearing loss can be severe. If the diagnosis of middle ear cholesteatoma is confirmed, seek early medical treatment and follow the doctor’s instructions, and strive to preserve and improve hearing function.