Table 1. Summary of Reported Cases of Petrous Apex Cholesterol Granuloma Treated via the Endonasal Endoscopic Approach.
| Author | Age, Sex | Preoperative Symptoms | Location of CG in Relation to Sphenoid Sinus (SS) | Symptoms on Follow-Up (Length of Follow-Up, mo) | Procedure | Complication | Symptomatic Recurrence |
|---|---|---|---|---|---|---|---|
| Griffith and Terrell (1996)3 | 34, M | Disequilibrium | Protruding into the posterior SS, bony erosion | Asymptomatic (18) | TS drainage of cyst; wide opening of the cyst cavity | Transient epistaxis | None |
| 24, M | Hearing loss, V3 hypesthesia | Protruding into SS | Asymptomatic after 3rd OR (12) | 1st: subtemporal transzygomatic approach; 2nd: TS drainage of cyst; 3rd: TS drainage of cyst and wide opening of the cyst cavity | None | Recurrence 2 mo after 1st OR; recurrence 2 mo follow-up after 2nd OR; no recurrence after 3RD OR | |
| Michaelson et al (2001)8 | 13, F | H/A, VIth nerve palsy | Abutting the posterior SS | Asymptomatic (6) | TS drainage of cyst; wide opening of the cyst cavity; marsupialization | None | None |
| DiNardo et al (2003)9 | 62, F | Disequilibrium | Abutting the posterior SS, separated by a thin layer of bone | Asymptomatic (12) | TS drainage of cyst; wide opening of the cyst cavity | None | None |
| Presutti et al (2006)10 | 38, M | H/A, VIth nerve palsy, increasing vertigo | Abutting the posterolateral wall of the SS | Asymptomatic (3) | TS drainage of cyst; wide opening of the cyst cavity; placement of T-shaped stent | None | None |
| Oyama et al (2007)11 | 28, F | Hemifacial pain | Protruding in the posterior SS, separated by a thin layer of bone | Asymptomatic (24) | TS drainage of cyst; wide opening of the cyst cavity | None | None |
| Georgalas et al (2008)7 | 30, M | Facial palsy, sensorineural hearing loss, vertigo | Abutting the posterolateral SS | Asymptomatic (120) | TS drainage of cyst; wide opening of the cyst cavity; marsupialization | None | None |
| 13, M | H/A, VIth nerve palsy | Sphenopetrous lesion, almost completely obliterating SS | Asymptomatic (72) | 1st: middle fossa approach; 2nd: TS drainage of cyst; wide opening of the cyst cavity; marsupialization | None | Recurrence after 1st OR (time to recurrence not specified); no recurrence after 2nd OR | |
| 44, F | H/A | Protruding into the posterior SS | Asymptomatic (24) | TS drainage of cyst; wide opening of the cyst cavity; marsupialization | None | None | |
| Samadian et al (2009)12 | 28, F | H/A, VIth nerve palsy, hearing loss | Protruding in the posterior SS, separated by a thin layer of bone | Asymptomatic (48) | TS drainage of cyst; wide opening of the cyst cavity; marsupialization; placement of a Silicone tube drain | None | None |
| Zanation et al (2009)13 | 8 patients | All had H/A; 2 had occasional vertigo | No detail | No detail | TS: 2; TS with carotid lateralization: 3; IP approach: 3; drainage of cyst and stenting | None | One recurrence at 2.5 y after 1st OR |
| Present case | 19, F | H/A, VIth nerve palsy | Abutting the posterior SS | Asymptomatic to date (15) | 1st: TS drainage of cyst; wide opening of the cyst cavity; partial marsupialization; 2nd: TS and IP for drainage of cyst; very wide opening of the cyst cavity; marsupialization; placement of a Doyle stent | After 1st OR: delayed epistaxis | Recurrence 4 mo after 1st OR; no recurrence yet after 2nd OR |
CG, cholesterol granuloma; H/A, headache; IP, infrapetrous; mo, months; OR, operation; SS, sphenoid sinus; TS, transsphenoidal.