In cases where an expanded cholesteatoma has extensively eroded the petroclival bones, marsupialization of the cholesteatoma cavity without matrix removal through an endoscopic transsphenoidal approach is a feasible and safe option. This approach avoids CSF rhinorrhea and injury to critical structures which may be underlying and adherent to the cholesteatoma matrix, and periodic debridements address the disease satisfactorily.
Hardy et al. (Tue,) studied this question.