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DOI: 10.1055/s-0038-1640527
Transsphenoidal and infralabyrinthine approach in cholesterol granulomas of the petrous apex
Introduction:
Cholesterol granulomas are among the most common benign tumors of the petrous apex and often present with uncharacteristics symptoms. The exposed position presents the ENT surgeon with a number of intraoperative problems, so the choice of the appropriate access route is of particular importance.
Methods:
In the retrospective analysis of cholesterol granulomas of the petrous apex, nine patients were compared with regard to their surgical approach (transsphenoidal vs. infralabyrinthine) and their postoperative symptoms.
Outcome:
In 3 cases where the transsphenoidal approach was chosen, all patients were symptom-free, with the postoperative function of the inner ear as well as of the balance remaining unrestricted. No complaints were also achieved in the 6 patients who underwent surgery via the infralabyrinthine approach. With preserved inner ear function, the treatment of conductive hearing loss with the Vibrant Sound bridge took place in 3 cases, 2 patients received conventional hearing aids and one patient was treated by a TORP.
Discussion:
Both the anatomy of the petrous apex and its pathology should determine the operative approach of the surgeon. In our opinion the navigated transsphenoidal and infralabyrinthine approach both represent a safe alternative.
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No conflict of interest has been declared by the author(s).
Publication History
Publication Date:
18 April 2018 (online)
© 2018. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Stuttgart · New York