Learning Objectives:

Objective: To evaluate the application of transcochlear approach for temporal bone cholestetoma with facial weakness.

Methods: We reviewed our institutional experience in the management of patients with temporal bone cholestetoma .The surgical approaches and techniques were discussed.

Results: 6 temporal bone cholestetoma patients with facial weakness were reviewed. Transcochlear approach was used for these patients. Immediately post-operative facial function was as the same level as pre-operatively. During follow-up, facial function was recovered in 4 cases and no recurrence was detected by annually MRI scan.

Conclusion: adequate explosion is important for total removal of the temporal bone cholesteatoma. recurrence can be avoid with eliminate all the debris and matrix of cholesteatoma. in case with facial nerve involved, transcochlear approach with facial nerve rerouting can got enough vision of lesion.

Key words: temporal bone cholestetoma, treatment strategy, transcochlear approach