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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Neurol+Surg+Rep
2016 ; 77
(1
): e017-22
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Upper Nasopharyngeal Corridor for Transnasal Endoscopic Drainage of Petroclival
Cholesterol Granulomas: Alternative Access in Conchal Sphenoid Patients
#MMPMID26929897
Turan N
; Baum GR
; Holland CM
; Ahmad FU
; Henriquez OA
; Pradilla G
J Neurol Surg Rep
2016[Mar]; 77
(1
): e017-22
PMID26929897
show ga
Background?Cholesterol granulomas arising at the petrous apex can be treated via
traditional open surgical, endoscopic, and endoscopic-assisted approaches.
Endoscopic approaches require access to the sphenoid sinus, which is technically
challenging in patients with conchal sphenoidal anatomy. Clinical Presentation?A
55-year-old woman presented with intermittent headaches and tinnitus. Formal
audiometry demonstrated moderately severe bilateral hearing loss. CT of the
temporal bones and sella revealed a well-demarcated expansile lytic mass. MRI of
the face, orbit, and neck showed a right petrous apex mass measuring
22?×?18?×?19?mm that was hyperintense on T1- and T2-weighted images without
enhancement, consistent with a cholesterol granuloma. The patient had a conchal
sphenoidal anatomy. Operative Technique?Herein, we present an illustrative case
of a low-lying petroclival cholesterol granuloma in a patient with conchal
sphenoidal anatomy to describe an alternative high nasopharyngeal corridor for
endoscopic transnasal transclival access. Postoperative Course?Postoperatively,
the patient's symptoms recovered and no complications occurred. Follow-up imaging
demonstrated a patent drainage tract without evidence of recurrence.
Conclusion?In patients with a conchal sphenoid sinus, endoscopic transnasal
transclival access can be gained using a high nasopharyngeal approach. This
corridor facilitates safe access to these lesions and others in this location.