Cholesteatomas can result in a spectrum of intra-temporal and intracranial complications. Symptoms related to these complications may include headaches, trismus/temporomandibular joint disorders, and otologic symptoms such as hearing loss, tinnitus, otorrhea, vertigo, and disequilibrium [1,2]. As cholesteatomas erode through the temporal bone to the posterior fossa dura, cochlear fistula and carotid dehiscence have been described, in addition to facial nerve paresis, hemifacial spasm,