A cholesteatoma is a nonmalignant growth that can affect the middle ear or inner ear and present with hearing loss. It is less common for it to cause disequilibrium. A cholesteatoma can sometimes be seen simply on physical examination with an otoscope. In some cases, imaging (with CT or MRI or both) may be helpful in confirming the diagnosis and characterizing its extent. Patients with cholesteatomas should consult with an otolaryngologist because the treatment is surgical.