Iannella Giannicola, Savastano Ersilia, Pasquariello Benedetta, Re Massimo, Magliulo Giuseppe
Organi di Senso Department, Sapienza University of Rome, Rome, Italy.
Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy.
J Neurol Surg Rep. 2016 Mar;77(1):e46-9. doi: 10.1055/s-0035-1571205.
Petrous bone cholesteatomas (PBCs) are epidermoid cysts, which have developed in the petrous portion of the temporal bone and may be congenital or acquired. Cholesteatomas arising in this region have a tendency to invade bone and functional structures and the middle and posterior fossae reaching an extensive size. Traditionally, surgery of a giant PBC contemplates lateral transtemporal or middle fossa microscopic surgery; however, in recent years, endoscopic surgical techniques (primary or complementary endoscopic approach) are starting to receive a greater consensus for middle ear and mastoid surgeries. We report the rare case of an 83-year-old Caucasian male affected by a giant cholesteatoma that eroded the labyrinth and the posterior fossa dura and extended to the infralabyrinthine region, going beyond the theca and reaching the first cervical vertebra. The giant cholesteatoma was managed through a combined approach (microscopic and, subsequently, complementary endoscopic approach). In this case report, we illustrate some advantages of this surgical choice.
岩骨胆脂瘤（PBCs）是表皮样囊肿，发生于颞骨的岩部，可能是先天性或后天性的。该区域产生的胆脂瘤有侵犯骨质和功能结构以及中、后颅窝并发展到较大体积的倾向。传统上，巨大岩骨胆脂瘤的手术考虑经颞外侧或中颅窝显微镜手术；然而，近年来，内镜手术技术（初次或辅助内镜入路）在中耳和乳突手术中开始获得更多认可。我们报告了1例罕见的83岁白种男性患者，患有巨大胆脂瘤，该胆脂瘤侵蚀了迷路和后颅窝硬脑膜，并延伸至迷路下区域，超出了被膜并累及第一颈椎。该巨大胆脂瘤通过联合入路（显微镜下，随后辅助内镜入路）进行处理。在本病例报告中，我们阐述了这种手术选择的一些优势。
