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Endoscopic transnasal removal of cholesteatomas of the temporal bone pyramid with extension to the clivus
Ist Teil von
Interdisciplinary neurosurgery : Advanced techniques and case management, 2020-09, Vol.21, p.100727, Article 100727
Ort / Verlag
Elsevier B.V
Erscheinungsjahr
2020
Link zum Volltext
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
•Transnasal surgery of the skull base.•This surgery has its own characteristics in view of the tumor and its location.•Transsphenoidal access optimal for the removal of cholesteatoma region of the slope.
Cholesteatomas of the temporal bone pyramid can invade the clivus through the petrous apex. As these cases are extremely scarce in world literature, an optimal approach to their treatment has not been determined.
We present two clinical cases: a patient with an apical cholesteatoma of the temporal bone pyramid extending to the clivus and a patient with a massive cholesteatoma of the temporal bone pyramid, also extending to the clivus according to the classification proposed by Sanna.
The apical cholesteatoma was removed totally, while the massive cholesteatoma was subjected to subtotal removal. In the second case, the duration of postoperative hospital stay was 7 days, while in the first case, hospitalization time was extended to 12 days as a result of postoperative cerebrospinal fluid leakage (due to intraoperative dura mater damage during the removal of the cyst capsule) and consequent revision duraplasty, further substantiating the need for the most delicate separation of the tumor capsule from the underlying dura mater.
As a result of the development of modern endoscopic endonasal technologies in skull base surgery, effective removal of cholesteatomas of temporal bone pyramid with extension to the clivus has become possible using minimally invasive and organ-saving methods.