Learning Objectives:

Objective: To report the experience on the diagnosis and treatment of petrous bone cholesteatoma (PBC) in our clinic.

Methods: The medical records of 23 patients with PBC who underwent surgery between 2013 and 2015 in our department were retrospectively analyzed with respect to the classification, surgical approach, facial nerve function and its management, auditory function, and recurrence.

Results: The median age of these patients was 32 years old. Otorrhea, hearing loss and facial nerve palsy were the most common symptoms. All of these patients presented with hearing loss and 16 patients with facial nerve palsy. 18 cases were supralabyrinthine, 1was infralabyrinthine-apical, 2were massive and 2were apical. Three patients had undergone previous mastoid surgery. The surgical approaches varied according to the classification, and transchochlear approach was chosen for 15 cases(one patients operated with the endoscope assistance), transmastoid approach was chosen for 7 cases, combination of middle cranial fossa and translabyrinth approach was chosen for 1case. The median follow-up was 14months. Postoperatively, 17 patients were total deafness. Recurrence of cholesteatoma was found in 2 cases, and revision surgery was performed.

Conclusion: The surgical approach should be decided according to the classification, extent of the lesion , hearing level ,and facial nerve function. Complete removal of cholesteatoma should be prioritized over the preservation of residual hearing level and facial nerve function.