1. These aims are conflicting and this makes cholesteatoma surgery extremely challenging. 2. In other words, the aims of cholesteatoma treatment form a hierarchy. 3. The general objective of cholesteatoma surgery has two parts. 4. The paramount objective is the complete removal of cholesteatoma . 5. Collapse or retraction of the eardrum can cause conductive hearing loss or cholesteatoma . 6. Surgical removal is required once a cholesteatoma has formed. 7. Once the debris is cleared, cholesteatoma can give rise to a number of appearances. 8. In addition, cholesteatoma inadvertently left by a surgeon usually regrows as an epidermal cyst. 9. Some conditions are amenable to surgical intervention such as middle ear fluid, cholesteatoma , otosclerosis. 10. The need to fully remove a progressive disease like cholesteatoma is the surgeon's first priority.