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Surgery is often required for the treatment of cholesteatoma. If left untreated, the destructive and expansile nature of this condition can result in destruction to the bony structures in the middle ear, such as the middle ear bones (ossicles) and the hearing organ (cochlear) both resulting in hearing loss, the balance organ (labyrinth) to cause giddiness, the bony covering of the facial nerve to cause facial weakness and even the base of the skull (tegmen tympani) to cause involvement of the brain. If left untreated it can also be infected, causing pain, discharge and fever.