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.
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Editor Recruited By: Ravi N. Samy, MD, FACS
Cholesterol granuloma drainage
Expanding petrous apex lesion (asymptomatic) or symptomatic (headache, retro-orbital pain, hearing loss, dizziness, facial paresis/twitching)
Only hearing ear, elderly, frail/numerous comorbidities
operating microscope, facial nerve monitoring, otologic drill, microinstruments
anesthesia evaluation, CT scan, MRI scan, audiogram
Anatomy And Landmarks
jugular bulb, internal carotid artery, cochlear promontory
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
Deafness, tympanic membrane perforation, internal carotid artery injury, jugular bulb injury
Disclosure of Conflicts
None as it relates to this video
All the listed co-authors on the video
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
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