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The current video presents the surgical management of a cholesterol granuloma of the anterior petrous apex, through the infracochlear approach. The video contains patient's medical history, pre-operative radiological evaluation, surgical approach to the lesion and radiological follow up. Surgery was conducted by an otology and skull base team in a tertiary referral center. The patient is a 49-years-old male, who was referred to our center for a four months history of right tinnitus and fullness. The clinical evaluation was unremarkable and the audiometric testing showed a right sensorineural hearing loss with normal contralateral hearing. A high-resolution CT-scan of the temporal bone was performed showing a lesion occupying the right petrous apex and eroding the cochlea. In a subsequent MRI scan, the lesion appeared hyperintense in both T1- and T2-weighted images. Those radiological features prompted us to the diagnosis of a cholesterol granuloma, and the selected treatment was a drainage via infracochlear approach. The infracochlear approach, firstly described by Giddings et al.  in 1991, represents a direct route to the petrous apex, that can be chosen in selected cases with favorable anatomical conditions and that allows respecting of the hearing mechanism. After surgical drainage of the granuloma, no worsening of the pure tone threshold was confirmed by the audiological evaluation. The hospital stay was uneventful and the patient was discharge one day postoperatively. One-year postoperative MRI scan showed signal reduction of the cholesterol granuloma.
This article was published in the following journal.
Name: American journal of otolaryngology
Cholesterol granuloma is a benign mass that commonly involves the petrous apex but rarely affects other structures, such as the mastoid cavity. It is diagnosed histologically by the presence of giant ...
Intraosseous petrous apex schwannomas are an exceedingly rare entity; little is known about their epidemiology, natural history, and post-operative outcomes.
Cholesterol granuloma is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses....
[This corrects the article DOI: 10.1055/s-0040-1702612.].
Orbitofrontal cholesterol granuloma is a rare occurrence. Here, we present a case involving a 64-year-old man with a recurrent orbitofrontal cholesterol granuloma treated by the Modified Lothrop (Draf...
Surgeons usually choosing drainage tube for laparoscopic cholecystectomy according to their experiences but not guidelines. We design a RCT to evaluate the role of drainage in LC surgery a...
To identify: 1. The most frequent pathologies affecting pterygopalatine fossa, lateral recess of the sphenoid sinus, petrous apex, Meckel's cave, cavernous sinus, infratemporal fos...
The purpose of this study is to evaluate the effect of different suture material on the incidence of suture granuloma.
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Common bile duct stones in clinical manifestations of biliary colic, obstructive jaundice, cholangitis, pancreatitis and other symptoms. At present, thanks to the rapid development of mini...
Cholesterol which is contained in or bound to high-density lipoproteins (HDL), including CHOLESTEROL ESTERS and free cholesterol.
Cholesterol which is contained in or bound to low density lipoproteins (LDL), including CHOLESTEROL ESTERS and free cholesterol.
A non-neoplastic inflammatory lesion, usually of the jaw or gingiva, containing large, multinucleated cells. It includes reparative giant cell granuloma. Peripheral giant cell granuloma refers to the gingiva (giant cell epulis); central refers to the jaw.
Fatty acid esters of cholesterol which constitute about two-thirds of the cholesterol in the plasma. The accumulation of cholesterol esters in the arterial intima is a characteristic feature of atherosclerosis.
A disorder of the skin, the oral mucosa, and the gingiva, that usually presents as a solitary polypoid capillary hemangioma often resulting from trauma. It is manifested as an inflammatory response with similar characteristics to those of a granuloma.
Cholesterol is a waxy steroid metabolite found in the cell membranes and transported in the blood plasma. It is an important structural component of mammalian cell membranes, where it is establishes proper membrane permeability and fluidity. Cholesterol ...
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...