title: Cholesteatoma in the petrous apex.
abstract: Six patients with extensive cholesteatoma in the petrous pyramid are reported. All patients had a facial palsy of long duration. In five patients with a history of otitis media, radiographic examinations and surgical explorations revealed chronic inflammatory changes in the middle ear, which suggested that the cholesteatoma in the petrous pyramid was associated with a preceding otitis media. Only in one patient, without a past history of otitis media, was the cholesteatoma assumed to be of congenital origin. The cholesteatoma was totally removed in five patients using a translabyrinthine approach and in one by a middle cranial fossa approach. Control of middle ear infection, obliteration of the mastoid petrosal cavity, and facial nerve repair were supplementary but significant surgical problems.
mesh_terms: D000328:Adult; D001847:Bone Diseases / Q000150:complications / Q000601:surgery; D002781:Cholesteatoma / Q000150:complications / Q000601:surgery*; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D010579:Petrous Bone