Surgery  
All the operations in this study were performed under local infiltration under general anesthesia with 2% lidocaine and epinephrine (1: 100,000), in which Karl Storz (4 mm diameter, 18 cm long) rigid endoscope (0, 30, 45) and Zeiss operating microscope were used to study each group.
Penetration of postaural and canal, dissection of postaural sulcus of arched postaural incision flap, cutting of musculoperiosteal flap and bone canal in the latter half of contact, exposure and standard harvest of fascia of temporal muscle, detached skin canal measured from 12 o’clock to 6 o’clock position, and a front extended open attic area are all surgical technical contents of MES group. The whole range of cholesteatoma can be observed by gastrostomy with drill bit. To observe whether there is residual cholesteatoma matrix in attic area after cholesteatoma resection, we can observe it directly with or without a mirror. Relocation of the tympanic membrane flap can be performed with the support of the perichondrium, provided that the cartilage removed from the tragus reconstructs the attic (Figure 2). Osteoplasty can be performed with prosthesis when the ossicles are destroyed.
The technique of holding the endoscope in the left hand and cutting the skin along the tympanic membrane ring at 6 o’clock and 12 o’clock for EES group operation; The symptoms of bleeding can be controlled by cotton gauze. A pubic facetomy can be performed. Scrapers or gouges and mallets. Check the upper attic area after cholesteatoma resection, and use 0 and 30 endoscopy. The tympanic membrane flap was repositioned after rebuilding the attic through cartilage (Figure 3). Osteoplasty can be performed with prosthesis when the ossicles are destroyed.