Title:
Cholesterol granulomas of the petrous apex; endonasal endoscopic approach
Authors:
P. V. Tomazic , U. Nemetz , W. Koele , C. Walch , E. M. Braun , G. P. Hammer , V. Gellner , G. Clarici , H. Braun , 1 M. Mokry and H. Stammberger 1
Institutions:
1ENT­­University­Hospital­Graz,­Medical­University­Graz,­ Department­of­Neurosurgery,­Medical­University­Graz,­ Graz,­Austria
Keywords:
Petrous­apex;­cholesterol­granuloma;­CT/MRI­fusion;­computer­assisted­navigation;­marsupialisation;­skull­ base
Pages:
263 - 267
Abstract:
Cholesterol granulomas of the petrous apex; endonasal endoscopic approach. Objective: Cholesterol­granu- lomas­are­benign­lesions­that­sometimes­occur­on­the­petrous­apex­(PA).­We­report­our­experience­using­an­endoscopic­ endonasal­approach­to­remove­PA­cholesterol­granulomas. Material and methods:­A­retrospective­patient­chart­analysis­was­conducted­at­a­tertiary­care­university­hospital. Results:­Four­patients­(3­females,­1­male)­were­included­in­this­study.­Patients­ages­ranged­from­27­to­78­years.­­Computed­ tomography­(CT)­and­magnetic­resonance­imaging­(MRI)­for­diagnosis­and­computer-assisted­navigation­were­­performed.­ The­most­common­symptom­was­abducens­nerve­palsy.­The­largest­granuloma­measured­5­×­2­cm­and­was­located­on­ the­left­side. An endoscopic endonasal approach was chosen and navigation was applied (3/4 patients) to identify the optimal area for opening­the­granuloma.­No­complications­occurred,­and­patients­were­free­from­recurrence­during­the­follow-up­period. Conclusion:­The­endoscopic­endonasal­approach­to­PA­cholesterol­granulomas­is­feasible­and­safe.­Intra-operative­ navigation is recommendedto identify the position of the internal carotid artery and determine the safest area for opening the­granuloma­without­damaging­the­artery.­Another­advantage­of­this­approach­is­an­easier­follow-up­through­­diagnostic­ nasal­endoscopy.
Issue:
Vol. 9, 2013, 4th trimester


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Cholesterol granulomas of the petrous apex; endonasal endoscopic approach