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Diagnosis, classification and surgical management of Petrous Bone Cholesteatomas: Gruppo Otologico experience of 200 consecutive patients

Presenting Author: Mario Sanna

Published online by Cambridge University Press:  03 June 2016

Mario Sanna ,
Sampath Chandra Prasad Rao ,
Gianluca Piras  and
Enrico Piccirillo
Mario Sanna
Affiliation:
Gruppo Otologico
Sampath Chandra Prasad Rao
Affiliation:
Gruppo Otologico
Gianluca Piras
Affiliation:
Gruppo Otologico
Enrico Piccirillo
Affiliation:
Gruppo Otologico
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Abstract

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Abstracts
Information
The Journal of Laryngology & Otology , Volume 130 , Supplement S3: Abstracts for the 10th International Conference on Cholesteatoma , May 2016 , pp. S13
Copyright
Copyright © JLO (1984) Limited 2016 

Diagnosis, classification and surgical management of Petrous Bone Cholesteatomas: Gruppo Otologico experience of 200 consecutive patients.

Objective: To review the classification and management of Petrous Bone Cholesteatomas (PBCs) at our center and the outcomes of facial nerve (FN) management in these lesions.

Study Design: Retrospective study.

Setting: A quarternary referral center in Italy for Skull Base pathology.

Patients: 200 patients with 201 PBCs were included in the study.

Interventions: All patients diagnosed radiologically to have PBCs were classified according to the Sanna Classification. All patients were surgically treated and followed up with radiology.

Main Outcome Measures: Classification of PBCs, surgical approach used, disease control and FN outcomes were analysed.

Results: Supralabyrinthine PBCs were the most common type with 92 (45.8%) cases followed by the Massive PBCs with 72 (35.8%) cases. Preservation of pre-operative facial nerve function was highest in the Infralabyrinthine (72.2%) and Infralabyrinthine-apical (73.3%) types. The Transotic Approach was used in 66 (32.8%) cases in this series. The MTCA – Type A was applied in 55 (27.3%) of the cases. An active management of the nerve (re-routing, anastomosis or grafting) was required in 53 (26.4%) cases. Post-operatively, of the 116 cases with FN HB Grade I and II, 107 (92.2%) cases retained the same grade or improved. Recurrence was seen in seven (3.5%) cases.