The ear is a very complex organ with components including the external auditory canal, tympanic membrane, middle ear cleft, ear bones as well as an inner ear. Occasionally, the ear canal infected and this can lead to recurrent drainage, hearing loss and injury to the structures of the ear. As well, occasionally cysts and growths can develop in the ear that will lead to destruction of the structures of the middle ear. The important requirements of a functional ear include hearing, normal sensation and a dry ear that does not lead to recurrent drainage or irritation. In the setting of recurrent drainage, hearing loss or infection, it may be required to perform surgery for certain infections or growths. One such growth is a cholesteatoma. A cholesteatoma is a skin cyst of the ear composed of ear drum skin that can erode into the ear structures and create what is called a conductive hearing loss. It often leads to chronic fluid drainage from the ear. Surgery may be required for this conidision. If surgery is required, your surgeon will likely order a CT scan of the temporal bones to further evaluate for the anatomy and integrity of the ear. The surgeon can then review the CT scan with you and show you the areas of disease that may require further intervention.Occasionally that intervention is as simple as a myringotomy tube or ear tube placement in the office. However, occasionally this may require surgery and the possible surgeries may include a tympanoplasty, mastoidectomy, ossicular reconstruction or tympanomastoidectomy. A tympanoplasty is repair of the injured tympanic membrane by grafting fat to the areas of perforation or retraction. A mastoidectomy includes drilling and removing areas of diseased bone in the mastoid air cells which are immediately behind the ear canal in the bony area behind the ear. Typically, all of this surgical work is done through the ear canal or a small incision behind the ear. Occasionally, this requires reconstruction of the ear bones, and this is called ossicular reconstruction. This part of the surgery is sometimes done in a staged fashion at a later date with a second surgery. Occasionally, a myringotomy or ear tube will be placed at the time of surgery. There are some risks of surgery including bleeding, infection, hearing loss, tinnitus, dizziness, continued perforation, continued otorrhea and rarely risks of facial paralysis, loss of taste and leakage of brain fluid. Your surgeon will be able to discuss your particular risks of surgery based upon your anatomy. Despite successful surgery, you may continue to have hearing loss and require hearing assistance such as a hearing aid. Long-term follow up is often required due to the sensitive nature of the ears. Occasionally numbness and pain will persist after surgery for several months. Most commonly, surgery is briefly discomforting and leads to a significant improvement of hearing as well as a dry ear. Please consult with your surgeon if you have any concerns or questions.