Skull Base 2005; 15(4): 263-267
DOI: 10.1055/s-2005-918618
CASE REPORT

Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Clinicoradiological and Surgical Considerations in the Treatment of Cholesterol Granuloma of the Petrous Pyramid

Ulrike Bockmühl1 , Hisham S. Khalil1 , Wolfgang Draf1
  • 1Department of Otorhinolaryngology, Head and Neck and Facial Plastic Surgery, Klinikum Fulda gAG, Teaching Hospital of the Philipps-University Marburg, Fulda, Germany
Further Information

Publication History

Publication Date:
10 October 2005 (online)

ABSTRACT

We describe a 71-year-old woman who complained of a 1-year history of double vision when looking to the left, numbness over the right cheek, intermittent tinnitus, and gradually increasing unsteadiness when walking. Computed tomography and magnetic resonance imaging revealed a cholesterol granuloma at the right pyramidal apex anterior to the internal auditory canal and a slight compression of the brainstem on the ipsilateral side. For surgical removal we used the transtemporal approach instead of the trans-sphenoidal approach to obtain better control over the internal carotid artery. To avoid the problems of stenting, the resulting dead space was obliterated with fat. We discuss the essential preoperative imaging, controversies in choosing the appropriate surgical approach, and developments in treatment.

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Ulrike BockmühlM.D. Ph.D. 

Department of Otorhinolaryngology, Head and Neck and Facial Plastic Surgery

Klinikum Fulda gAG, Teaching Hospital of the Philipps-University Marburg, Germany

Pacelliallee 4, 36043 Fulda, Germany

Email: u.bockmuehl.hno@klinikum-fulda.de