Petrous apex cholesterol granulomas: Evolution and management
Petrous apex cholesterol granulomas: Evolution and management
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DOI：
10.3171/jns.1997.86.5.0822
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发表时间：
1997-05-01
影响因子：
4.1
通讯作者：
AlMefty, O
中科院分区：
文献类型：
--
作者：
Eisenberg, MB;Haddad, G;AlMefty, O
石质尖端胆固醇肉芽肿是由于石质空气细胞的正常通气受阻而引起的，传统的治疗方法是通过经颞门静脉入路引流和支架置入。直接的结果是相当令人满意的，但复发率高达60%，在一些系列报道。作者总结了14例岩状尖端胆固醇肉芽肿的治疗经验。扩展中窝入路和岩窝入路分别用于8例和2例患者。所有患者均接受了肉芽肿和囊肿壁的完全切除，然后用带蒂的颞肌条封堵腔。平均随访3.8年无复发。4名未接受手术的患者正在接受临床随访和连续磁共振成像。此外，本系列的临床和影像学结果为这些病变的起源和持续增长提供了新的见解，并证实了以前仅在实验模型中描述的内容。结论：岩状顶点胆固醇肉芽肿具有连续的临床和影像学表现，提倡通过扩展中窝入路根根性切除。
Petrous apex cholesterol granulomas result from obstruction of the normal aeration of the petrous air cells and have traditionally been treated by drainage and stent placement via a transtemporal approach. The immediate results were quite satisfying, but recurrence rates as high as 60% have been reported in some series. The authors present their experience treating 14 patients with petrous apex cholesterol granulomas. An extended middle fossa approach and a petrosal approach were used for eight and two patients, respectively. All underwent complete removal of the granuloma and cyst wall followed by obliteration of the cavity with a pedicled strip of temporalis muscle. No recurrences were seen at a mean followup period of 3.8 years. Four patients who did not undergo surgery are being followed clinically and with serial magnetic resonance images. Additionally, the clinical and radiographic findings in this series give new insights into the origin and continued growth of these lesions and confirm what had been described previously only in experimental models. It is concluded that petrous apex cholesterol granulomas feature a continuum of both clinical and radiographic findings and radical removal via an extended middle fossa approach is advocated.