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Endoscopic trans-sphenoidal removal of cholesterol granuloma of the petrous apex: case report and literature review

Published online by Cambridge University Press:  26 October 2010

G Dhanasekar*
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Queen's Medical Centre, Nottingham, UK
N S Jones
Affiliation:
Department of Otolaryngology/Head and Neck Surgery, Queen's Medical Centre, Nottingham, UK
*
Address for correspondence: Mr G Dhanasekar, 6 Woodhayes Croft, Wolverhampton WV10 8PP, UK E-mail: [email protected]

Abstract

Objective:

We report a case of cholesterol granuloma of the petrous apex which was surgically treated via an endoscopic trans-sphenoidal approach.

Methods:

Case report and review of the literature concerning cholesterol granulomas of the petrous apex and their management.

Results:

The lesion was approached endoscopically via a bilateral sphenoidotomy with removal of the vomer. A large cholesterol granuloma was evacuated and marsupialised. The patient made an uneventful recovery.

Conclusion:

Trans-sphenoidal access to the petrous apex represents an alternative route for the drainage and ventilation of cholesterol granulomas. This approach is the technique of choice when the cholesterol granuloma abuts the posterior wall of the sphenoid sinus. The trans-sphenoid approach, unlike other lateral approaches to the petrous apex, spares cochlear and vestibular function and allows post-operative endoscopic follow up.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2010

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Footnotes

Presented at the British Rhinological Society meeting, 21 May 2010, Solihull, UK

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