Novel Application of Steroid-Eluting Stent in Petrous Apex Cholesterol Granuloma Approached Endonasally: A Case Series

Objective To describe the safety and efficacy of mometasone furoate-eluting stents in the management of petrous apex cholesterol granuloma approached through an endonasal endoscopic route and assess the restenosis rate.

Methods 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.

Results Four patients were included in the study: three were primary cases and one was undergoing his third revision. The steroid-eluting stent was placed successfully and safely in all patients with no dural or vascular injury. There was no restenosis in three patients at 4 months’ follow-up. One patient had an immediate restenosis that was debrided in clinic (revision case) at 1 week postoperatively and was patent at 3 months’ follow-up.

Conclusion Mometasone furoate-eluting stent 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.