Commentary “Petrous Temporal Bone Cholesteatoma: A New Classification and Long-Term Surgical Outcomes”

Moffat et al present 43 patients surgically treated for petrous bone cholesteatomas. Given that 10 patients had prior surgery and 13 suffered from chronic otitis media, their population was complex. Nonetheless, only four patients developed cerebrospinal fluid leakage, and the House-Brackmann grade of only four patients worsened across follow-up. Based on their rates of hearing preservation, the authors favor aggressive resection to preserve residual hearing. However, fewer than 5% of their patients had serviceable preoperative hearing. The follow-up was extremely long, with a median of more than 10 years. Overall, these impressive patient outcomes and anatomically based classification scheme showcase the senior author's tremendous clinical experience with this challenging entity.