Does a cholesteatoma herniated to the temporal lobe needs surgery always or it can be left alone? (no symptoms)

Odd question: By definition a cholesteotoma originates from a space that involves the ear drum & a cavity outside the protective coverings of the brain. Such an invasion can allow germs from outside the brain to enter the sensitive spaces covering the brain & lead to meningitis or encephalitis. I have never dealt with such a case but would never consider differing surgery if it involved me or my family.