[Facial nerve and petrous bone cholesteatoma]

The diagnosis and treatment of petrous bone cholesteatoma is a challenge to aural surgeons. Seven patients with extensive petrous bone cholesteatomas which invaded the labyrinth and fallopian canal are presented. These cholesteatomas originated as secondary to acquired lesions. The cases were evaluated according to the clinical features, the intraoperative findings, the radiological findings, and the surgical approaches. In this series, six patients presented with facial paralysis associated with profound or total deafness. The transtemporal lateral approach was used in all the cases. Acute facial nerve palsy or facial nerve pareses progressing to palsy in patients with chronic ear disease should be studied radiographically for petrous bone cholesteatoma, even if there is no physical evidence of cholesteatoma.