J Neurol Surg Rep 2016; 77(01): e46-e49
DOI: 10.1055/s-0035-1571205
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Giant Petrous Bone Cholesteatoma: Combined Microscopic Surgery and an Adjuvant Endoscopic Approach

Giannicola Iannella
1  Organi di Senso Department, Sapienza University of Rome, Rome, Italy
,
Ersilia Savastano
1  Organi di Senso Department, Sapienza University of Rome, Rome, Italy
,
Benedetta Pasquariello
1  Organi di Senso Department, Sapienza University of Rome, Rome, Italy
,
Massimo Re
2  Department of Clinical Sciences, Polytechnic University of Marche, Ancona, Italy
,
Giuseppe Magliulo
1  Organi di Senso Department, Sapienza University of Rome, Rome, Italy
› Author Affiliations
Further Information

Publication History

16 June 2015

29 November 2015

Publication Date:
01 March 2016 (online)

Abstract

Petrous bone cholesteatomas (PBCs) are epidermoid cysts, which have developed in the petrous portion of the temporal bone and may be congenital or acquired. Cholesteatomas arising in this region have a tendency to invade bone and functional structures and the middle and posterior fossae reaching an extensive size. Traditionally, surgery of a giant PBC contemplates lateral transtemporal or middle fossa microscopic surgery; however, in recent years, endoscopic surgical techniques (primary or complementary endoscopic approach) are starting to receive a greater consensus for middle ear and mastoid surgeries. We report the rare case of an 83-year-old Caucasian male affected by a giant cholesteatoma that eroded the labyrinth and the posterior fossa dura and extended to the infralabyrinthine region, going beyond the theca and reaching the first cervical vertebra. The giant cholesteatoma was managed through a combined approach (microscopic and, subsequently, complementary endoscopic approach). In this case report, we illustrate some advantages of this surgical choice.