Cholesterol Granuloma Petrous Apex Revision
Video Type: CVideo- 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
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Author: Charles Poon
Published:
Specialties: Neurosurgery, Otolaryngology
Schools: University of Cincinnati CCHMC
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Loading...Contributors: Ravi N. Samy, M.D., F.A.C.S (University of Cincinnati / CCHMC) and Shawn Stevens, M.D.
Cholesterol granuloma recurrence at the petrous apex. The patient had a prior surgery performed without stenting. Revision surgery at UC performed with double-barrel stent placement.
External Related Links: www.cisurgeon.org www.youtube.com/user/cisurgeon
DOI: http://dx.doi.org/10.17797/vvmrb6t77g
Editor Recruited By: Ravi N. Samy, MD, FACS
Procedure
Cholesterol granuloma drainage
Indications
Expanding petrous apex lesion (asymptomatic) or symptomatic (headache, retro-orbital pain, hearing loss, dizziness, facial paresis/twitching)
Contraindications
Only hearing ear, elderly, frail/numerous comorbidities
Instrumentation
Setup
operating microscope, facial nerve monitoring, otologic drill, microinstruments
Preoperative Workup
anesthesia evaluation, CT scan, MRI scan, audiogram
Anatomy and Landmarks
jugular bulb, internal carotid artery, cochlear promontory
Advantages/Disadvantages
1. Advantages- outpatient procedure with minimal risk to hearing or postoperative morbidity
2. Disadvantages- can be technically challenging for a novice otologic surgeon; consider infralabyrinthine approach as well
Complications/Risks
Deafness, tympanic membrane perforation, internal carotid artery injury, jugular bulb injury
Disclosure of Conflicts
None as it relates to this video
Acknowledgements
All the listed co-authors on the video
References
1. Double-barrel stenting in infracochlear approach for drainage of petroux apex cholesterol granulomas. Shoman NM, Samy RN, Pensak ML. Laryngoscope. 2011 Mar;121(3):574-6. doi: 10.1002/lary.21420. Epub 2011 Jan 21. No abstract available. PMID: 21344437
Similar articles:
Petrous apex cholesterol granuloma aeration: does it matter? Castillo MP, Samy RN, Isaacson B, Roland PS.
Otolaryngol Head Neck Surg. 2008 Apr;138(4):518-22. doi: 10.1016/j.otohns.2007.12.012. PMID: 18359365
Bilateral cholesterol granulomas. Verret DJ, Samy RN. Otol Neurotol. 2005 Sep;26(5):1041-4. No abstract available. PMID: 16151356
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