Endoscopic Endonasal Resection of Cholesterol Granuloma of the Petrous Apex

Abstract

Submit Manuscript | http://medcraveonline.com asosseptal flap has been used to permitlong-termpatency of drainage site [4]. Material and MethodsA 43years old man presented with 6 month history of intermittent right hemicranial headache and ipsilateral conductive hearingloss. The patient had no historyof head trauma. The MRI demonstrated a large and expansile right petrous apex lesion hyper intense on both T1-and T2-weighted scans, without diffusion restriction or internal contrast enhancement. The CT scan showed and expansile and lyticlesion with surrounded bony erosion (Figures 1-4). Surgical techniqueA medial and unilateral trans sphenoidal trans clival approach with internal carotidartery lateralization combined with transpterygoidinfrapetrous approach was indicated because of the location of the lesion. Team surgery is mandatory when there is manipulation of the internal carotid artery and a risk of vascular injury [5]. Bilateral sphenoidotomies provides more room for instrumentation and allow four-hand surgery by a team of surgeons an otolaryngology and a neurosurgeon, however unilateral sphenoidotomie approach can be a viable option and less invasive alternative. The sinonasal mucosa was de congested with topical epinephrine 1:2000. The partial Volume