Middle ear cholesteatoma is a highly destructive, inflammatory middle ear lesion. Currently, the only treatment is surgical extraction, but the rate of recurrence is as high as 40%. Thus, alternative interventions are desperately needed. Like other inflammatory diseases — such as arthritis and Crohn’s disease — middle ear cholesteatoma has inflammatory feedback loops that drive further dysregulation. This means that existing treatments that target a shared pathway could also be of use for middle ear cholesteatoma. So, a recent review summarized the current knowledge about these feedback loops in middle ear cholesteatoma and identified over 100 drugs already in use for other diseases that could potentially be repurposed. The researchers then narrowed the list down to 13 drugs with potential for fast translation. While more research is needed to determine if any of these drugs are effective middle ear cholesteatoma treatments, this review lays the groundwork for the development of pharmaceutical interventions for this harmful disease.