Combined Surgical Approach to Giant Cholesteatoma: A Case Report and Literature Review.
OBJECTIVE
Cholesteatomas can grow to a remarkable size before clinically making their presence felt. Managing giant cholesteatomas and their complications can become a challenge for the otological surgeon.


METHODS
We describe a case of a giant congenital cholesteatoma of the mastoid in an adult. The lesion extended to the sigmoid sinus, jugular bulb, carotid canal, occipital condyle, and the lateral portion of the first cervical vertebra. Surgical excision was performed using a combined microscopic and endoscopic surgical approach.


RESULTS
Our combined surgical technique enabled a more accurate removal of the cholesteatoma than a microscopic approach alone, with no surgical complications or damage to the structures affected by the disease.


CONCLUSIONS
Using endoscopic instruments to manage giant cholesteatomas can help to avoid complications and improve surgical radicality.
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy gkmcaz@hotmail.it.
Diego
D
Cazzador
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy.
Niccolò
N
Favaretto
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy.
Elisabetta
E
Zanoletti
Department of Neurosciences, Otolaryngology Section, University of Padova, Italy.
Alessandro
A
Martini
D000368:Aged; D001301:Audiometry, Pure-Tone; D002781:Cholesteatoma / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D046089:Hearing Loss, Mixed Conductive-Sensorineural / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*; D010579:Petrous Bone / Q000601:surgery; D014057:Tomography, X-Ray Computed
cholesteatoma; congenital; endoscopy; giant; mastoid; skull base