Petrous Apex Cholesterol Granuloma Presenting as Endolymphatic Hydrops: A Case Report.
- Author:
Ho Chan KIM
1
;
Yun Suk AN
;
Joong Ho AHN
Author Information
1. Department of Otolaryngology, Asan Medical Center, Ulsan University School of Medicine, Seoul, Korea. meniere@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Cholesterol granuloma;
Petrous apex;
Endolymphatic hydrops
- MeSH:
Cholesterol;
Diet, Sodium-Restricted;
Diplopia;
Emergencies;
Endolymphatic Hydrops;
Endolymphatic Sac;
Gadolinium;
Granuloma;
Headache;
Hearing;
Hearing Loss;
Humans;
Hypesthesia;
Magnetic Resonance Imaging;
Meniere Disease;
Spasm;
Temporal Bone;
Tinnitus;
Vertigo
- From:Clinical and Experimental Otorhinolaryngology
2009;2(3):151-154
- CountryRepublic of Korea
- Language:English
-
Abstract:
A petrous apex cholesterol granuloma (PACG) is the most common lesion of the petrous apex mass. Affected patients present with various symptoms such as hearing loss, vertigo, headache, tinnitus, facial spasms, and diplopia. We report the case of a 32-yr-old man with a PACG, who was first misdiagnosed with Meniere's disease. He was placed on a low-salt diet, and prescribed medication from another hospital, for several months, but the symptoms persisted and worsened. The patient presented to the emergency room complaining of left facial twitching and numbness. To rule out a central neurological lesion, temporal bone magnetic resonance imaging was carried out and a 2.5 cm mass with high signal intensity on T1- and T2-weighted imaging, without gadolinium enhancement, was found. Because of the hearing and facial problems, we drained cholesterol-bearing material via an infralabyrinthine approach using a computer aided image-guided surgical device, the BrainLAB(R). After the operation, the vertigo and hearing loss were no longer present. It is likely that the patent's Meniere's disease-like symptoms were due to the compression of the endolymphatic sac by a PACG.
