Resection of petrous apex cholesteatoma via endoscopic trans-sphenoidal approach
10.3760/cma.j.issn.1673-0860.2012.01.009
- VernacularTitle:经鼻内镜蝶窦进路岩尖胆脂瘤切除
- Author:
Rui XU
1
;
Qiu-Hang ZHANG
;
Ke-Jun ZUO
;
Geng XU
Author Information
1. 中山大学附属第一医院,耳鼻咽喉科医院
- Keywords:
Endoscopy;
Otorhinolaryngologic surgical procedures;
Sphenoid sinus;
Cholesteatoma
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2012;47(1):30-33
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce our experience of resection of petrous apex cholesteatoma through endoscopic,transnasal,trans-sphenoidal approach in 3 cases,and present a surgical technique of intracystic resection of lesion which yielded a relatively stable long-term outcome.Methods Resection of parasellar and petrous apex cholesteatoma via endoscopic transsphenoidal approach was performed in three patients between 2001 and 2006.Surgical technique was as follows: the ethmoid and sphenoid sinuses were opened under endoscope,the petrous apex was accessed by drilling skull base bone at the lateral wall of sphenoid sinus and anterior to the internal carotid artery,the cyst wall of cholesteatoma was incised and expanded,then intracystic removal of cholesteatoma was achieved by the suction,curette and rinsing.Results The petrous apex cholesteatoma in all 3 patients were removed clearly by endoscopic,transnasal,trans-sphenoidal surgery in one time.Before surgery,two patients with headache and orbital apex syndrome had a remarkable improvement just on the day after operation and completely recovered in 1-4 weeks.No postoperative complications happened in all three patients.All patients had no recurrence in symptoms and no imaging evidences of recurrence at a follow-up of 3-7 years. Conclusion The petrous apex cholesteatoma around the parasellar region could be treated by intracystic removal via endoscopic,transnasal,transsphenoidal approach,without the need to strip and remove the cyst wall,and the long-term efficacy was reliable.
