Comprehensive treatment of middle ear cholesteatoma involves preoperative treatment, followed by a radical inside-out aticoanthromastoidectomy with cartilage-perichondrium reconstruction of the tympanic membrane. If possible, a reconstruction of the posterior wall of the external auditory canal is done. In all other cases mastoid obliteration with bone pate, cartilage or artificial bone is performed. In case of intact stapes a type III tympanoplasty is performed; in the absence of stapes suprastructures TORP ossicular chain reconstruction is performed when there are no indications for a second-look surgery. Post-operative follow-up of patients includes regular checkups and DW-MRT in some cases.