Choi Kevin J, Jang David W, Zomorodi Ali R, Codd Patrick J, Friedman Allan, Abi Hachem Ralph
Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University, Durham, North Carolina, United States.
Department of Neurosurgery, Duke University, Durham, North Carolina, United States.
J Neurol Surg B Skull Base. 2019 Oct;80(5):500-504. doi: 10.1055/s-0038-1675751. Epub 2018 Nov 27.
This study describes the safety and efficacy of mometasone furoate eluting stents in the management of petrous apex cholesterol granuloma approached through an endonasal endoscopic route and assesses the restenosis rate. Consecutive patients undergoing endoscopic endonasal marsupialization of a petrous apex cholesterol granuloma at a tertiary referral center who had a mometasone furoate eluting stent placed intraoperatively were reviewed in a retrospective fashion. Postoperative endoscopy was used to determine success of surgery and stenting. Five patients were included in the study, three were primary cases and two patients had revision surgeries performed. The steroid eluting stent was placed successfully and safely in all patients with no dural or vascular injuries. The average follow-up duration was 10.6 months. There was no restenosis in three patients and one patient had an immediate restenosis that was debrided in clinic (revision case). This was patent at the 16 months follow-up. One patient also developed stenosis, 4 months after surgery due to sphenoid sinusitis. Mometasone furoate eluting stents are safe and effective in the primary management of petrous apex cholesterol granuloma. Further studies are needed to assess their efficacy in revision cases and for long term results.
本研究描述了糠酸莫米松洗脱支架经鼻内镜途径治疗岩尖胆固醇肉芽肿的安全性和有效性，并评估了再狭窄率。 对一家三级转诊中心连续接受内镜下经鼻岩尖胆固醇肉芽肿袋形缝合术且术中置入糠酸莫米松洗脱支架的患者进行回顾性研究。术后通过内镜检查确定手术和支架置入是否成功。 本研究纳入了5例患者，其中3例为初发病例，2例接受了翻修手术。所有患者均成功且安全地置入了类固醇洗脱支架，未发生硬脑膜或血管损伤。平均随访时间为10.6个月。3例患者未发生再狭窄，1例患者术后即刻出现再狭窄，在诊所进行了清创（翻修病例）。在16个月的随访中该部位保持通畅。1例患者术后4个月因蝶窦炎也出现了狭窄。 糠酸莫米松洗脱支架在岩尖胆固醇肉芽肿的初始治疗中安全有效。需要进一步研究以评估其在翻修病例中的疗效及长期效果。
