Case 1: A 54-year-old female had complained of bilateral complete hearing loss, left facial palsy and gate disturbance. A diagnosis of cholesteatoma was given from the findings of left ear drum, X-ray, vestibular function test, C-T scanning, and so on. Cholesteatoma was removed as completely as possible from the left temporal bone by a left paramedian suboccipital craniotomy. Histopathological examination confirmed it to be cholesteatoma.
Case 2: A 33-year-old male had complained of right severe hearing loss and facial palsy. A diagnosis was made as cholesteatoma in the right temporal bone from the X-ray, vestibular function test, C-T scanning, and so on. Cholesteatoma was removed as completely as possible by a right middle cranial fossa approach. Histopathological examination revealed the mass to be cholesteatoma.
Cholesteatoma of the temporal bone is rare. It is difficult to diagnose it before surgery. We could differenciate it from the cerebellopontine angle lesions, particularly acoustic neurinoma in two cases with temporal bone cholesteatoma.
We conclude from our experience of present cases that trans-labyrinthine approach is best in case of the temporal bone cholesteatoma with ipsilateral complete hearing loss and facial palsy and trans-labyrinthine approach plus suboccipital craniotomy or suboccipital-trans-temporal combined approach is better in such a case.