[Clinical characteristics and surgical efficacy in patients with petrous bone cholesteatoma]

The clinical data of 24 petrous bone cholesteatoma (PBC) patients (13 males and 11 females) aged (35±13) years who underwent surgical treatment in the Department of Otolaryngology, Peking Union Medical College Hospital from January 2015 to May 2023 were retrospectively analyzed. The clinical characteristics, surgical strategies and prognosis of PBC were explored. The results showed that the main clinical manifestations of patients were hearing loss (100.0%, 24/24) and facial paralysis (87.5%, 21/24). According to the Sanna classification, the majority of cases were supralabyrinthine type (45.8%, 11/24) and extensive type (41.7%, 10/24). Subtotal petrosectomy was the most commonly used surgical approach (45.8%, 11/24), followed by the infratemporal fossa Type B approach (25.0%, 6/24). Intraoperative facial nerve intervention was performed in 19 cases, with a postoperative facial nerve function improvement rate of 52.6% (10/19). Hearing reconstruction was conducted in four patients. During the follow-up period of 24-124 (44±26) months, only one patient experienced recurrence 43 months after surgery due to incomplete removal of lesions during the operation. The current study suggests that the surgical approach for PBC should be selected based on the lesion condition, and sufficient exposure and complete removal of the cholesteatoma matrix during surgery can prevent lesion recurrence.