A cholesteatoma represents an abnormal migration or implantation of epithelium behind the tympanic membrane. Depending on the type of cholesteatoma, the patient may have a variety of presenting symptoms. Nonetheless, most all patients with a cholesteatoma will seek treatment initially from a primary care provider. This course will help the PCP to be familiar with the variety of ways that a patient with a cholesteatoma can present and either be prepared to make the diagnosis of a cholesteatoma or direct the patient with suspicious symptoms to an Otolaryngologist for definitive diagnosis and treatment.