Transsphenoid Endoscopic Management of Petrous Apex Cholesterol Granuloma
Transsphenoid Endoscopic Management of Petrous Apex Cholesterol Granuloma
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经蝶内镜治疗岩尖胆固醇肉芽肿
DOI：
10.1016/s0194-59989670289-9
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
J. Terrell
中科院分区：
文献类型：
--
作者：
A. Griffith;J. Terrell
石质尖端的胆固醇肉芽肿最早由Manasse于1917年报道。它也可能出现在颞骨的其他充气部分，被认为是由于创伤或其他病理过程阻塞了充气的颞骨的空气细胞。这种阻塞导致空气细胞内的负压，最终引起粘膜水肿、组织破裂和出血，并伴有分解产物（如胆固醇）的积累。由此产生的病变在组织病理学上表现为对胆固醇晶体的非特异性肉芽肿反应。岩尖的原发性胆固醇肉芽肿可能与先前的耳科手术或创伤有关，尽管许多患者没有明显的易感因素。颅V、VI、VII或VIII神经缺损常引起常见的初始症状，包括复视、听力丧失、眩晕、面神经无力或面肌痉挛。头痛也很常见，因为这些病变通常在诊断前变得很大。准确的岩尖胆固醇肉芽肿术前诊断包括带或不带钆增强的磁共振成像（MRI）扫描以及计算机断层扫描（CT）扫描。这些研究是互补的，两者都是区分的必要条件
Cholesterol granuloma of the petrous apex was first reported by Manasse in 1917.1 It may also arise in other pneumatized portions of the temporal bone and is thought to arise when air cells of pneumatized temporal bone become obstructed by trauma or some other pathologic process. This obstruction leads to negative pressure within the air cells, causing eventual mucosal edema, tissue breakdown, and hemorrhage, with the accumulation of breakdown products such as cholesterol) The resulting lesion is histopathologically characterized by a nonspecific granulomatous reaction to the cholesterol crystals. Primary cholesterol granuloma of the petrous apex may be associated with prior otologic surgery or trauma, although many patients have no apparent predisposing factors. Deficits of cranial nerves V, VI, VII, or VIII frequently account for the common initial symptoms, which include diplopia, hearing loss, vertigo, and facial nerve weakness or hemifacial spasm. Headaches are also common because these lesions often attain large size before diagnosis? The accurate preoperative diagnosis of cholesterol granuloma of the petrous apex includes a magnetic resonance imaging (MRI) scan with and without gadolinium enhancement, as well as a computed tomography (CT) scan. These studies are complementary and both are essential to distinguish