Naga Rahul, Sudhan M D, Reddy Lakku V Manohar, Dutta Angshuman
Department of Otolaryngology, Head and Neck Surgery, CHAF, Bengaluru, Karnataka 560007 India.
Department of Neurosurgery, CHAF, Bengaluru, karnataka 560007 India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4644-4647. doi: 10.1007/s12070-024-04712-w. Epub 2024 May 2.
The petrous apex is medial most part of temporal bone, which is surrounded by vital structures. Cholesterol granuloma is the most common benign lesion of the petrous apex. Symptoms are related to mass effect and/or direct involvement of closely adjacent vital structures. The lesions can be manged either by open surgery via craniotomy or through the newer endoscopic approach. Case report and review of the literature concerning cholesterol granulomas of the petrous apex and their management. The lesion was approached endoscopically trans nasal and trans sphenoid and cholesterol granuloma was excised and marsupialised. Post operative patient recovery was uneventful. Endonasal Endoscopic approach has significantly lower complication rate when compared to open approaches. Petrous apex lesions are rare and need a multidisciplinary team approach for optimal management. By endoscopic approach one can remove lesion or marsupialize the sac with natural drainage into sinus and result in better prognosis and minimal chance of recurrence. Endonasal procedure has also lower complication rates and shorter median follow-up than open approaches.
岩尖是颞骨最内侧的部分，周围环绕着重要结构。胆固醇肉芽肿是岩尖最常见的良性病变。症状与肿块效应和/或紧邻重要结构的直接受累有关。这些病变可通过开颅手术或更新的内镜方法进行处理。关于岩尖胆固醇肉芽肿及其处理的病例报告和文献综述。该病变通过经鼻和经蝶窦内镜入路进行处理，切除胆固醇肉芽肿并进行袋形缝合术。术后患者恢复顺利。与开放手术相比，鼻内镜入路的并发症发生率显著更低。岩尖病变罕见，需要多学科团队方法进行最佳处理。通过内镜方法，可以切除病变或将囊袋进行袋形缝合术，使其自然引流至鼻窦，从而获得更好的预后和最低的复发几率。鼻内手术的并发症发生率也低于开放手术，且中位随访时间更短。
