Cholesteatoma is the most controversial topic within the field of middle ear surgery. Depending on the individual, many surgeons have used the two different techniques of intact canal wall and canal-wall-down tympanomastoidectomy for approaching the middle ear. Opinions conflict as to which approach provides the best visualization of different locations in the middle ear. In this article, a clinical case of recurrence of middle ear cholesteatoma which completely destroyed temporal bone, close to the inner carotid artery 20 years after canal-wall-down surgical treatment is presented.
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