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Cholesteatoma is an ear pathology that is quite commonly seen in this office. Cholesteatoma is an abnormal invasion of external dry skin into the area behind inside of the eardrum. This invasion means that skin from the ear canal gains access to the areas of the ear behind the eardrum, usually occurring from a perforation of the eardrum or a retraction pocket of the eardrum. Cholesteatomas may result in severe chronic otitis media infections of the mastoid bone behind the ear this can result in fevers and chills with drainage of the ear. This is known as “mastoiditis”. The drainage can be quite foul. The hearing bones may also be destroyed. Depending on the size of the cholesteatoma, ear surgery ranging from a mild eardrum repair (tympanoplasty) to a larger mastoid bone drilling operation (mastoidectomy) may be necessary. Cholesteatoma cannot be treated by antibiotics to remove the abnormal skin. Antibiotics may prevent the cholesteatoma from overt infection (otitis media) until surgery can be done. The surgery for cholesteatoma is usually outpatient. The recovery is usually within several days.