Complete Recovery of Sensorineural Hearing Loss Following Endoscopic Transsphenoidal Surgery for a Petrous Apex Cholesterol Granuloma: Case Report

Patient: Male, 64 Final Diagnosis: Petrous apex cholesterol granuloma Symptoms: Right ear sensorineural hearing loss Medication: — Clinical Procedure: Endoscopic endonasal transsphenoidal surgery Specialty: Neurosurgery Objective: Rare disease Background: Cholesterol granulomas of the petrous apex may impinge surrounding cranial nerves, leading to neurological impairments such as hearing loss. Less invasive endoscopic techniques are gaining popularity as the mainstay of therapy for this lesion. Case Report: We present a case of petrous apex cholesterol granuloma causing mild sensorineural hearing loss. An endoscopic endonasal transsphenoidal approach was successfully performed to partially resect and aerate the lesion. The auditory function on the affected side was completely restored after surgery. The patient experienced no post-operative complications. Conclusions: This case report highlights the advantages of using an endoscopic transsphenoidal surgical approach in cases of petrous apex cholesterol granuloma, including the potential for this less invasive technique to restore sensorineural hearing loss.

[1]  M. Samadian,et al.  Endoscopic Transnasal Approach for Cholesterol Granuloma of the Petrous Apex , 2015, Case reports in neurological medicine.

[2]  B. Isaacson,et al.  Cholesterol granuloma and other petrous apex lesions. , 2015, Otolaryngologic clinics of North America.

[3]  D. Eytan,et al.  Surgical outcomes after endoscopic management of cholesterol granulomas of the petrous apex: a systematic review. , 2014, Neurosurgical focus.

[4]  K. Park,et al.  Endoscopic transsphenoidal drainage of an aggressive petrous apex cholesterol granuloma: unusual complications and lessons learnt , 2013, The Journal of Laryngology & Otology.

[5]  J. Fernandez-Miranda,et al.  Endoscopic endonasal approach to cholesterol granulomas of the petrous apex: a series of 17 patients: clinical article. , 2012, Journal of neurosurgery.

[6]  J. Fernandez-Miranda,et al.  Endoscopic endonasal approach to cholesterol granulomas of the petrous apex: a series of 17 patients , 2012 .

[7]  R. Carrau,et al.  Endoscopic Endonasal Management of Recurrent Petrous Apex Cholesterol Granuloma , 2011, Journal of Neurological Surgery—Part B.

[8]  H. Sudhoff,et al.  Petrous Apex Cholesterol Granuloma Involving the Sphenoid Sinus , 2011, Ear, nose, & throat journal.

[9]  A. Chacko,et al.  Endoscopic transsphenoidal approach to petrous apex cholesterol granulomas , 2010, British journal of neurosurgery.

[10]  H. Saleh,et al.  Endoscopic endonasal approaches to management of cholesterol granuloma of the petrous apex. , 2010, Skull base : official journal of North American Skull Base Society ... [et al.].

[11]  A. Hagr.  Hearing Improvement after Partial Labyrinthectomy: Resection of petrous apex cholesterol granuloma. , 2010, Sultan Qaboos University medical journal.

[12]  P. Tran Ba Huy,et al.  Endoscopic transsphenoidal surgery for cholesterol granulomas involving the petrous apex , 2008, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[13]  P. Roland,et al.  Lesions of the petrous apex: diagnosis and management. , 2007, Otolaryngologic clinics of North America.

[14]  M. Pensak,et al.  Cholesterol Granulomas , 1954, Current opinion in otolaryngology & head and neck surgery.

[15]  A. Teramoto,et al.  Petrous apex cholesterol granuloma treated via the endoscopic transsphenoidal approach , 2007, Acta Neurochirurgica.

[16]  S. Telian,et al.  Rapid expansion in a previously indolent cholesterol cyst: a need for lifelong follow-up. , 2006, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[17]  U. Bockmühl,et al.  Clinicoradiological and surgical considerations in the treatment of cholesterol granuloma of the petrous pyramid. , 2005, Skull base : official journal of North American Skull Base Society ... [et al.].

[18]  R. Jackler,et al.  A New Theory to Explain the Genesis of Petrous Apex Cholesterol Granuloma , 2003, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[19]  D. Brackmann,et al.  Surgical Management of Petrous Apex Cholesterol Granulomas , 2002, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.