Background: Cholesteatoma is a potentially life-threatening inflammatory lesion that causes hearing loss, ear discharge, and ear pain, and serious complications. For the past several decades, most studies of cholesteatoma have been restricted to microscopic ear surgery. However, a growing body of evidence suggests endoscopic ear surgery is a safe, minimally invasive approach for cholesteatoma management. This thesis aim to investigate and compare the clinical effect between endoscopic and microscopic ear surgery of cholesteatoma.

Materials and methods: The retrospective study included 186 patients with cholesteatoma who received endoscopic or microscopic ear surgery from 11 otorhinolaryngology centers between November 2016 and March 2021. Patients were followed-up for at least 1 year. Audiometry improvement, treatment cost, time, graft success rate and recurrence rate were assessed after surgery.

Inclusion Criteria:

• postoperative pathologically were confirmed cholesteatoma with or without mastoid involvement
• the extent of disease was confirmed by preoperative HRCT temporal bone
• undergoed microscopic and/or endoscopic surgery for cholesteatoma including primary or revision surgery

Exclusion Criteria:

• were lacking in clinical characteristics
• had not preoperative audiometric data
• missed the follow-up data
• were lacking in surgical times
• were microscopic combined endoscopic ear surgery

1. Patients who postoperative pathologically were confirmed cholesteatoma with or without mastoid involvement. The extent of disease was confirmed by preoperative HRCT temporal bone.
2. The patients undergoed microscopic and/or endoscopic surgery for cholesteatoma including primary or revision surgery.
3. have completely clinical characteristics, follow-up data and/or postoperative audiometric data