The perforation of the eardrum will generally heal without surgery. In some cases, however, instead of normally healing, the skin of the eardrum can grow through the hole into the middle ear. If an infection is present, the skin will continue to grow into the middle ear and will become a tumor of the ear termed cholesteatoma. Cholesteatomas are NOT a form of cancer. They are benign tumors. As they grow, they can look like an onion peel of white skin formed into a ball. They can destroy the bones of hearing as they grow, especially when the ear is infected or if water gets into the middle ear with other infections.