Korean J Otorhinolaryngol-Head Neck Surg.  2019 Jan;62(1):60-63. 10.3342/kjorl-hns.2017.00395.

Endoscopic-Assisted Infralabyrinthine Approach to Petrous Apex Cholesterol Granuloma

• Na G
• Bae S
• Lee JM
• Moon IS

• KMID: 2433176
• DOI: http://doi.org/10.3342/kjorl-hns.2017.00395

Abstract

A cholesterol granuloma is the most common primary lesion of the petrous apex, and accounts for 40% of the pathologies that arise in this region. The primary treatment for symptomatic lesions is by surgery to decompress and drain or to completely remove the lesion. Here we describe the use of infralabyrinthine approach to access a lesion through the temporal bone and completely remove it with the assistance of a 0-degree endoscope. A 43-year-old man visited our clinic for diplopia. Magnetic resonance imaging revealed a 2.3-cm cholesterol granuloma located in the left petrous apex that caused deviation of the left abducens nerve. The tumor was completely removed using the endoscopic-assisted infralabyrinthine approach; the patient is currently being followed up, and there is no evidence of disease recurrence. This case report describes the successful completion of a petrous apex cholesterol granuloma that preserved the cochlear and vestibular systems.

Keyword

Abducens palsy; Cholesterol granuloma; Endoscopic-assisted; Petrous apex tumor

MeSH Terms

Abducens Nerve
Adult
Cholesterol*
Diplopia
Endoscopes
Granuloma*
Humans
Magnetic Resonance Imaging
Pathology
Recurrence
Temporal Bone
Cholesterol