Petrous bone cholesteatoma: management and outcomes.
OBJECTIVE
Cholesteatoma of the petrous bone is a rare pathology that grows slowly and is often asymptomatic. High clinical suspect is recommended for its diagnosis. With the advancement of imaging, clinical diagnosis is confirmed and follow up is assured. The present study is presented to state our experience in management of petrous bone cholesteatoma (PBC) and an overview of the outcome results.


METHODS
This study was a retrospective case review conducted at a private quaternary referral center. From January 1984 to October 2004, 93 of 2,739 patients with chronic otitis media with cholesteatoma were treated surgically for PBC with varying location types.


RESULTS
The mean age in this study was 46 years. Ninety-four percent of patients presented with hearing loss. Facial paralysis constituted 55% of the presented manifestations and grade VI palsy was the most common. A massive type of PBC was found to affect 45% of patients and it was mainly the acquired pathology. The surgical approaches varied according to the class type of PBC. Postoperative complications were minimal, and follow up was carried out after 1 year from the surgery date.


CONCLUSIONS
Petrous bone cholesteatoma presents difficulties in its diagnosis and treatment. Adequate history-taking, high clinical suspicious, with the advancement of imaging techniques made its diagnosis more feasible. Improvement of the lateral skull base approaches rendered possible safe, adequate, and complete removal of the pathology.
Gruppo Otologico, Piacenza, Italy. ahmomran95@yahoo.com
Ahmed
A
Omran
Giuseppe
G
De Denato
Enrico
E
Piccirillo
Olga
O
Leone
Mario
M
Sanna
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002781:Cholesteatoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000379:methods*; D010579:Petrous Bone; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed