Clinical characteristics and prognosis of cholesteatoma otitis media with peripheral facial palsy OBJECTIVE: To investigate the clinical characteristics and prognostic factors affecting cholesteatoma otitis media with peripheral facial palsy. METHODS: The clinical data of 21 cases of cholesteatoma otitis media with peripheral facial palsy treated by surgery were retrospectively analyzed, and their morbidity characteristics and intraoperative pathology were counted. RESULTS: The onset of facial palsy due to cholesteatoma was predominantly slow (76.2%), and the most common site of occurrence of intraoperative facial nerve exposure was the tympanic segment (87.5%). 7 cases (33.3%) of coexisting exolymphatic fistula and 10 cases (47.6%) of coexisting meningeal exposure were found intraoperatively. There was no significant difference in the rate of good postoperative facial nerve recovery (HB grade I-II) between incomplete facial palsy and complete facial palsy, and the rate of good treatment outcome was 52.4% in all cases. The good recovery rate of facial nerve function in the group with onset of facial palsy <1 month was significantly higher than that in the group with ≥1 month. CONCLUSION: The most common site of cholesteatoma otitis media with peripheral facial palsy is the tympanic segment, which often coexists with external lymphatic fistula and meningeal exposure. Open mastoidectomy and local decompression of the facial nerve are effective ways to treat cholesteatoma otitis media with facial palsy, and the time of onset of facial palsy affects the recovery of facial nerve function after surgery, which should be performed as early as possible.