Petrous bone cholesteatoma [Neurosurgery Wiki]

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====== Petrous bone cholesteatoma ======
[[Petrous bone]] cholesteatoma is a rare pathologic entity and maybe a difficult surgical challenge because of the potential involvement of the [[facial nerve]], [[carotid artery]], [[dura mater]], [[otic capsule]] and superior petrosal or [[lateral sinus]]. 

Eight patients (nine ears) who underwent endoscope-assisted petrous bone surgery for [[cholesteatoma]]. [[Pure tone audiometry]], [[magnetic resonance imaging]] were performed at preoperatively, and at approximately 12 months postoperatively.

Endoscope assisted surgery was performed in 8 patients and 9 ears. Of these patients, 6 were male and 2 were females. The median age was 19,5 (range 7-52) years. The [[hearing]] was able to preserved in 8 ears (8/9). Recurrence disease was observed one ear in long term follow up (1/9). In another one patient, cholesteatoma pearl was removed in the office.

Endoscope-assisted surgery can allow removal of cholesteatoma of [[petrous apex]] with preserving hearing. It also provides to remove the cholesteatoma via [[transmastoid approach]] for perilabyrinthine space as "minimally invasive surgery" instead of [[middle fossa approach]] that is standard surgical procedure. In apical and peri-labyrinthine cholesteatomas, endoscopes allow to preserve hearing with middle fossa approach instead of trans-otic/ trans-labyrinthine/trans-cochlear approach
((Orhan KS, Çelik M, Polat B, Aydemir L, Aydoseli A, Sencer A, Güldiken Y.
Endoscope-Assisted Surgery for Petrous Bone Cholesteatoma with Hearing
Preservation. J Int Adv Otol. 2019 Dec;15(3):391-395. doi: 10.5152/iao.2019.7212.
PubMed PMID: 31846917.
)).