Middle ear cholesteatoma is not a true tumor and is a cystic structure that includes the cyst wall, cyst contents, and outer layer of granulation tissue. It can be complicated with chronic suppurative otitis media, which can destroy the surrounding bone and present with severe intracranial and extracranial complications. The affected ear may have prolonged pus flow with blood, and the pus often has a peculiar foul odor due to secondary infection by corrosive bacteria; some people do not have pus flow in the early stages; there may be high or low pitched tinnitus. Tinnitus is not present in the early stages. Tympanic membrane perforations are located in the relaxed, tense posterior superior margin; early limited cholesteatoma in the primary superior tympanic chamber may not cause significant hearing loss. If the auditory chain is disrupted, hearing loss may be the first diagnosis. Secondary cholesteatomas generally have a more severe conductive or mixed hearing loss. Because cholesteatoma acts as a bridge between the defective auditory bones, hearing loss may be less pronounced even if there is partial destruction of the auditory bones. Hearing exam: Hearing loss may be mild or even normal. Because cholesteatoma does not only damage the hearing, but also causes more and more aggressive damage, which may eventually lead to facial neuropathy, vestibular pathology, vertigo, intracranial infection, brain abscess and other dangerous complications, it should be treated surgically as soon as possible. The purpose of surgery is to completely remove diseased tissue, reconstruct hearing, strive for dry ears, and prevent otogenic intracranial and extracranial complications from occurring. There are various surgical procedures to treat cholesteatoma otitis media, and the appropriate treatment plan is chosen according to the condition. Antibiotic medication can only temporarily control the infection and reduce the symptoms, but cannot remove the internal cholesteatoma lesion, so medication is only used as an aid and preparation for surgical treatment.