Endoscopic Removal of Petrous Cholesteatoma via Trans-canal Supra-labyrinth Approach: A Case Report

Petrous cholesteatoma is an entity of significant clinical ramifications especially concerning surgical risks it poses due to close proximity with vital skull-base neurovascular structures. Despite the challenges, surgical extirpation is still the treatment of choice. Conventional methods comprise external trans-mastoid routes through trans-labyrinth, retro-sigmoid, and middle cranial fossa. In this paper, we present a man native to Borneo, previously surgically treated for cholesteatoma who presented with a recurrence at the petrous apex. It was excised entirely via endoscopic trans-canal supra-labyrinth approach. Endoscopic removal is currently gaining favor amongst skull-base surgeons as more complex cases have been dealt successfully and reported worldwide. Nonetheless, it is an intricate procedure that requires a highly skilled and confident operator which demands experience.