Skip to main content
SpringerLink
Log in

Petrous bone cholesteatoma: our experience of 20 years and management of two giant cases affecting rhinopharynx

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. King TT, Benjamin JC, Morrison AW (1989) Epidermoid and cholesterol cysts in the apex of the petrous bone. Br J Neurosurg 3:451–461. https://doi.org/10.3109/02688698909002831

    Article  CAS  PubMed  Google Scholar 

  2. de Souza CE, Sperling NM, da Costa SS, Yoon TH, Abdel Hamid M, de Souza RA (1989) Congenital cholesteatomas of the cerebellopontine angle. Am J Otol 10:358–363

    PubMed  Google Scholar 

  3. Isaacson B, Kutz JW, Roland PS (2007) Lesions of the petrous apex: diagnosis and management. Otolaryngol Clin North Am 40:479–519. https://doi.org/10.1016/j.otc.2007.03.003

    Article  PubMed  Google Scholar 

  4. Sanna M, Zini C, Gamoletti R, Frau N, Taibah A, Russo A, Pasanici E (1993) Petrous bone cholesteatoma. Skull Base Surg 3:201–213. https://doi.org/10.1055/s-2008-1060585

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sanna M, Pandya Y, Mancini F, Sequino G, Piccirillo E (2011) Petrous bone cholesteatoma: classification, management and review of the literature. Audiol Neurootol 16:124–136. https://doi.org/10.1159/000315900

    Article  PubMed  Google Scholar 

  6. House JW, Brackmann DE (1985) Facial nerve grading system. Otolaryngol Head Neck Surg 93:146–147. https://doi.org/10.1177/019459988509300202

    Article  CAS  PubMed  Google Scholar 

  7. Meyerhoff WL, Truelson J (1986) Cholesteatoma staging. Laryngoscope 96:935–939

    Article  CAS  Google Scholar 

  8. Michaels L (1986) An epidermoid formation in the developing middle ear: possible source of cholesteatoma. J Otolaryngol 15:169–174

    CAS  PubMed  Google Scholar 

  9. Bartels LJ (1991) Facial nerve and medially invasive petrous bone cholesteatoma. Ann Otol Rhinol Laryngol 100:308–316. https://doi.org/10.1177/000348949110000408

    Article  CAS  PubMed  Google Scholar 

  10. Alvarez FL, Gómez JR, Bernardo MJ, Suárez C (2011) Management of petrous bone cholesteatoma: open versus obliterative techniques. Eur Arch Otorhinolaryngol 268:67–72. https://doi.org/10.1007/s00405-010-1349-1

    Article  PubMed  Google Scholar 

  11. Tutar H, Goksu N, Aydil U, Baştürk Tutar V, Kizil Y, Bakkal FK, Bayazit YA (2013) An analysis of petrous bone cholesteatomas treated with translabyrinthine transotic petrosectomy. Acta Otolaryngol 133:1053–1057. https://doi.org/10.3109/00016489.2013.811752

    Article  PubMed  Google Scholar 

  12. Gao Z, Gao G, Zhao WD, Jia XH, Yu J, Dai CF, Chen B, Chi FL, Wang J, Yuan YS (2019) Petrous bone cholesteatoma: our experience of 51 patients with emphasis on cochlea preservation and use of endoscope. Acta Otolaryngol 139:576–580. https://doi.org/10.1080/00016489.2019.1605455

    Article  PubMed  Google Scholar 

  13. Fisch U (1994) Tympanoplasty, mastoidectomy, and stapes surgery. Georg Thieme Stuttgart, New York

    Google Scholar 

  14. Moffat D, Jones S, Smith W (2008) Petrous temporal bone cholesteatoma: a new classification and long-term surgical outcomes. Skull Base 18:107–115. https://doi.org/10.1055/s-2007-991112

    Article  PubMed  PubMed Central  Google Scholar 

  15. Aubry K, Kovac L, Sauvaget E, Tran Ba Huy P, Herman P (2010) Our experience in the management of petrous bone cholesteatoma. Skull Base 20:163–167. https://doi.org/10.1055/s-0029-1246228

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kim M, An Y, Jang M, Cho Y, Chung J (2014) Hearing and facial function after surgical removal of cholesteatomas involving petrous bone. Clin Exp Otorhinolaryngol 7:264–268. https://doi.org/10.3342/ceo.2014.7.4.264

    Article  PubMed  PubMed Central  Google Scholar 

  17. Magliulo G (2007) Petrous bone cholesteatoma: clinical longitudinal study. Eur Arch Otorhinolaryngol 264:115–120. https://doi.org/10.1007/s00405-006-0168-x

    Article  PubMed  Google Scholar 

  18. Senn P, Haeusler R, Panosetti E, Caversaccio M (2011) Petrous bone cholesteatoma removal with hearing preservation. Otol Neurotol 32:236–241. https://doi.org/10.1097/MAO.0b013e3182001ef4

    Article  PubMed  Google Scholar 

  19. Danesi G, Cooper T, Panciera DT, Manni V, Côté DW (2016) Sanna classification and prognosis of cholesteatoma of the petrous part of the temporal bone: a retrospective series of 81 patients. Otol Neurotol 37:787–792. https://doi.org/10.1097/MAO.0000000000000953

    Article  PubMed  Google Scholar 

  20. Prasad SC, Piras G, Piccirillo E, Taibah A, Russo A, He J, Sanna M (2016) Surgical strategy and facial nerve outcomes in petrous bone cholesteatoma. Audiol Neurootol 21(5):275–285. https://doi.org/10.1159/000448584

    Article  PubMed  Google Scholar 

  21. Magliulo G, Terranova G, Sepe C, Cordeschi S, Cristofar P (1998) Petrous bone cholesteatoma and facial paralysis. Clin Otolaryngol Allied Sci 23:253–258. https://doi.org/10.1046/j.1365-2273.1998.00144.x

    Article  CAS  PubMed  Google Scholar 

  22. Omran A, De Denato G, Piccirillo E, Leone O, Sanna M (2006) Petrous bone cholesteatoma: management and outcomes. Laryngoscope 116:619–626. https://doi.org/10.1097/01.mlg.0000208367.03963.ca

    Article  PubMed  Google Scholar 

  23. Pandya Y, Piccirillo E, Mancini F, Sanna M (2010) Management of complex cases of petrous bone cholesteatoma. Ann Otol Rhinol Laryngol 119:514–525. https://doi.org/10.1177/000348941011900803

    Article  PubMed  Google Scholar 

  24. Mattox DE (2004) Endoscopy-assisted surgery of the petrous apex. Otolaryngol Head Neck Surg 130:229–241. https://doi.org/10.1016/j.otohns.2003.11.002

    Article  PubMed  Google Scholar 

  25. Orhan KS, Çelik M, Polat B, Aydemir L, Aydoseli A, Sencer A, Güldiken Y (2019) Endoscope-assisted surgery for petrous bone cholesteatoma with hearing preservation. J Int Adv Otol 15:391–395. https://doi.org/10.5152/iao.2019.7212

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Author notes

  1. Ya Liu and Fangyuan Wang contributed equally to this article and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery, 6th Medical Center, PLA General Hospital, Beijing, 100048, China

    Ya Liu, Fangyuan Wang, Hui Zhao, Shiming Yang & Zhaohui Hou

  2. College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China

    Ya Liu, Fangyuan Wang, Weidong Shen, Jun Liu, Hui Zhao, Weiju Han, Lei Chen, Hu Yuan, Pu Dai, Dongyi Han, Shiming Yang & Zhaohui Hou

  3. National Clinical Research Center for Otolaryngologic Diseases, Beijing, China

    Ya Liu, Fangyuan Wang, Weidong Shen, Jun Liu, Hui Zhao, Weiju Han, Lei Chen, Hu Yuan, Pu Dai, Dongyi Han, Shiming Yang & Zhaohui Hou

  4. Key Lab of Hearing Science, Ministry of Education, Beijing, China

    Ya Liu, Fangyuan Wang, Weidong Shen, Jun Liu, Hui Zhao, Weiju Han, Lei Chen, Hu Yuan, Pu Dai, Dongyi Han, Shiming Yang & Zhaohui Hou

Authors
  1. Ya Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fangyuan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Weidong Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jun Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hui Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Weiju Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lei Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hu Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Pu Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Dongyi Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Shiming Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Zhaohui Hou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zhaohui Hou.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, Y., Wang, F., Shen, W. et al. Petrous bone cholesteatoma: our experience of 20 years and management of two giant cases affecting rhinopharynx. Eur Arch Otorhinolaryngol 279, 2791–2801 (2022). https://doi.org/10.1007/s00405-021-06969-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-021-06969-1

Keywords

Search

Navigation