How can we manage chronic ear infections in perforated eardrum with cholesteatoma?

Hi doctor,

I am hoping to get a second opinion about my ear perforation. A few months back, I was swimming, and a wave sent me underneath the water, and it perforated my eardrum. After a few days, I had an ear infection and took some antibiotics, which cleared it up after a few days of pain. Since then, I have had two more infections, which seemed to be cleared up by antibiotics after seven days. I have seen a few ENT specialists, and they have just cleared out some earwax and not done anything much. The most recent ENT actually took time to look and said I would need tympanoplasty surgery as it is not healing after 6 to 7 months. They just did a CT scan to check behind the ear (they mentioned mastoidectomy a few times). The doctor seemed to think that the CT scan looked fine and that there was perhaps no reason for a mastoidectomy. However, they did see a small collection of tissue or something just behind the eardrum, and they said it could be a cholesteatoma. The second opinion I am after is around the doctor's preferred path forward. He said he would do the tympanoplasty to fix the eardrum and wait to see what happens regarding the potential cholesteatoma. My queries are: 1. If it is a cholesteatoma, could it be checked out simultaneously? 2. If it is the case, will they have to perform the surgery again and bust open the recently fixed eardrum? 3. The doctor said that cholesteatoma would be scary if I researched it, but the scans do not warrant a scare. Does it mean that it is not big enough to worry about? Some helpful information regarding my condition is the following. 1. It is my left ear. 2. It constantly feels just a little uncomfortable. I might describe it as an inflamed or full feeling, but nothing major. 3. If I lie with my other ear closest to the bed, my left ear gets more uncomfortable quickly and can become a little painful but not much pain. 4. I tried a couple of drying ear drops the day of the perforation, which caused a lot of pain (I guess whatever the ingredients were did not agree with my ear behind the eardrum). 5. The ear canal is not straight (they said a bone obstructs it a little, so it takes a slight left turn when looking in). 6. The perforation is on the left-hand side, right by the end of the eardrum. 7. The perforation has not healed at all. The doctor said it is folding in at the edges rather than healing back together. 8. I have always had a little trouble with water getting trapped in my ears. After all this, I have realized that it usually happens in my left ear, and the water typically leaves after a few hours. I think it is likely that the eardrum has been perforated more than once. 9. The eardrum looks a little whiter than normal, which I have been told is scarring. Thank you.