A perforation of the ear drum will generally heal without surgery. In some cases, however, instead of normally healing, the skin of the ear drum can grow through the hole into the middle ear. If infection is present, the skin will continue to grow into the middle ear and will become a tumor of the ear termed a 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.