Endoscopic Transcanal Approach to Remove Extensive Petrous Cholesteatoma

Petrous cholesteatoma is a rare clinical entity and surgical treatment is difficult because the anatomical location of the petrous bone. It poses potential surgical risk of injury to the facial nerve, labyrinth, carotid artery, dura and risk of cerebrospinal fluid leak. We report a case of a young patient with extensive petrous cholesteatoma with erosion of basal turn of the cochlea, posterior semicircular canals and dehiscence of tegmen, facial nerve, carotid canal and roof of the internal auditory canal. It was successfully treated via the endoscopic transcanal approach. This surgical approach provides an excellent anatomical advantage of reaching the tumor with minimal destruction to the vital structures. It minimises soft tissue dissection and left the normally aerated mastoid untouched. It gave excellent functional aesthetic outcome with complete disease clearance.