Endoscopic transsphenoidal drainage of a petrous apex cholesterol granuloma using a frontal sinus nasal stent: a case report with long term follow up.

British Journal of Neurosurgery
Brandon Lucke-WoldJeremy Ciporen

Abstract

Cholesterol granulomas of the petrous apex are benign cysts affecting 0.6 patients per 1 million. The pathophysiology involves cholesterol crystals and lipids that are surrounded by giant cells. The cholesterol deposits induce an inflammatory response likely from acute hemorrhage leading to the formation of a fibrous capsule. The capsule expands over time compressing nearby cranial nerves (VI-VIII), which can cause worsening symptoms. Surgical resection has been shown to provide excellent improvement in symptoms. Historically, open approaches such as the infracochlear, infralabyrinthine, and middle fossa have been used. Herein we present a case showing the feasibility and clinical utility of using an endoscopic endonasal transclival approach for treatment of these tumors. A 44-year-old female presented with history of intermittent double vision, dizziness, nausea, and headaches for 3 years. She developed a partial left CN6 palsy with significant diplopia and episodes of left facial weakness. The worsening symptoms prompted presentation to the ED where MRI and CT scan revealed a left petrous apex lesion (1.8 × 1.7 cm) with hyperintensity on T1 and T2 imaging, suggestive of cholesterol granuloma. She underwent an endoscopic trans...Continue Reading

References

Nov 30, 2016·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Shawn M StevensRavi N Samy
May 13, 2017·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Cameron C WickBrandon Isaacson
Sep 15, 2017·Surgical Neurology International·Saeed BanaamaYasin Temel
Oct 7, 2017·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Golda GrinblatMario Sanna
Jun 24, 2018·European Annals of Otorhinolaryngology, Head and Neck Diseases·V PatronM Hitier
Jun 25, 2018·Practical Radiation Oncology·Stephen A MihalcikUNKNOWN PROST-QA Consortium
Dec 7, 2018·Current Opinion in Otolaryngology & Head and Neck Surgery·Michael A KohanskiNithin D Adappa

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.

Related Papers

Ear, Nose, & Throat Journal
Jason P HuntPeter L Rigby
Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Stephane Tringali, Fred H Linthicum
The British Journal of Radiology
A G CliftonG B Brookes
© 2022 Meta ULC. All rights reserved