Ya Liu1,2,3,4, Fangyuan Wang1,2,3,4, Weidong Shen2,3,4, Jun Liu2,3,4, Hui Zhao1,2,3,4, Weiju Han2,3,4, Lei Chen2,3,4, Hu Yuan2,3,4, Pu Dai2,3,4, Dongyi Han2,3,4, Shiming Yang1,2,3,4, Zhaohui Hou5,6,7,8. 1. Department of Otolaryngology Head and Neck Surgery, 6th Medical Center, PLA General Hospital, Beijing, 100048, China. 2. College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China. 3. National Clinical Research Center for Otolaryngologic Diseases, Beijing, China. 4. Key Lab of Hearing Science, Ministry of Education, Beijing, China. 5. Department of Otolaryngology Head and Neck Surgery, 6th Medical Center, PLA General Hospital, Beijing, 100048, China. houstone301@yahoo.com. 6. College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China. houstone301@yahoo.com. 7. National Clinical Research Center for Otolaryngologic Diseases, Beijing, China. houstone301@yahoo.com. 8. Key Lab of Hearing Science, Ministry of Education, Beijing, China. houstone301@yahoo.com.
Abstract
PURPOSE: To demonstrate our experience in the treatment of petrous bone cholesteatoma (PBC). METHODS: Data of PBC patients in our hospital from January 2000 to December 2019 were collected. Surgical approaches and facial function were mainly discussed and compared with the literature. The management of 2 giant PBC cases affecting rhinopharynx has been demonstrated. RESULTS: The supralabyrinthine type was the most frequent type followed by the massive type. There were 5 cases with cholesteatoma extending into the clivus (2 cases), sphenoid (1 case) and rhinopharynx (2 cases). The translabyrinthine approach (40%) was our most frequently used approach followed by the middle fossa approach (36%) and the transmastoid approach (11%). There were 10 cases managed with the assistance of endoscope, including 3 cases with cholesteatoma extending into clivus, sphenoid and rhinopharynx separately. Obliteration of the cavity was performed in 70.3% (135/192) cases; 3 of them recurred. For the 2 giant PBC cases affecting rhinopharynx, traditional microscopic surgery assisted with transnasal endoscope was performed. The reduced exposure was beneficial for postoperative recovery, and the approach in the nasal cavity provided a permanent drainage for postoperative examination. CONCLUSION: Otologic endoscope combined with traditional microscopic surgery could reduce the exposure in surgery. For extremely extended cases of PBC, supplementary transnasal endoscopic approach deserves to be considered for the traditional temporal bone approach.
PURPOSE: To demonstrate our experience in the treatment of petrous bone cholesteatoma (PBC). METHODS: Data of PBC patients in our hospital from January 2000 to December 2019 were collected. Surgical approaches and facial function were mainly discussed and compared with the literature. The management of 2 giant PBC cases affecting rhinopharynx has been demonstrated. RESULTS: The supralabyrinthine type was the most frequent type followed by the massive type. There were 5 cases with cholesteatoma extending into the clivus (2 cases), sphenoid (1 case) and rhinopharynx (2 cases). The translabyrinthine approach (40%) was our most frequently used approach followed by the middle fossa approach (36%) and the transmastoid approach (11%). There were 10 cases managed with the assistance of endoscope, including 3 cases with cholesteatoma extending into clivus, sphenoid and rhinopharynx separately. Obliteration of the cavity was performed in 70.3% (135/192) cases; 3 of them recurred. For the 2 giant PBC cases affecting rhinopharynx, traditional microscopic surgery assisted with transnasal endoscope was performed. The reduced exposure was beneficial for postoperative recovery, and the approach in the nasal cavity provided a permanent drainage for postoperative examination. CONCLUSION: Otologic endoscope combined with traditional microscopic surgery could reduce the exposure in surgery. For extremely extended cases of PBC, supplementary transnasal endoscopic approach deserves to be considered for the traditional temporal bone approach.