Surgical Considerations in Addressing Cholesterol Granuloma of the Petrous Apex through an Infracochlear Approach.
ORL J Otorhinolaryngol Relat Spec
; 85(3): 172-176, 2023.
Article
em En
| MEDLINE
| ID: mdl-37019084
ABSTRACT
Cholesterol granuloma of the petrous bone is a foreign body giant cell reaction to cholesterol deposits with symptoms including hearing loss, vestibular dysfunction, and cranial nerve deficit as a result of cystic mass compression. Surgical treatment is often difficult to plan due to limited access to the lesion and possible injury to surrounding structures. We report on a case of petrous apex cholesterol granuloma drainage through an infracochlear approach. A 27-year-old female patient presented with acute diplopia due to left-sided abducens paralysis. Multislice computed tomography (MSCT) and magnetic resonance (MR) imaging described a 3.5-cm well-marginated lesion in petrous bone apex, compressing the left abducens nerve at the point of entry into the cavernous sinus, corresponding to cholesterol granuloma. The patients was surgically treated through a transcanal infracochlear approach, since preserving the external and middle ear conduction mechanisms was paramount for the patient. The patient was discharged on the second postoperative day and diplopia resolved within 5 days postoperatively. Six months after the surgery, her hearing on the left side is normal, and she remains symptom-free. This case underpins the value of preoperative planning when approaching the petrous apex, an anatomically complex area due to abundance of important neurovascular structures crowded in a narrow and confined region.
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Base de dados:
MEDLINE
Assunto principal:
Osso Petroso
/
Granuloma de Corpo Estranho
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article