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Petrous apex cholesterol granuloma: pictorial review of radiological considerations in diagnosis and surgical histopathology

Published online by Cambridge University Press:  26 February 2013

M Hoa ,
J W House ,
F H Linthicum Jr  and
J L Go
M Hoa
Affiliation:
House Clinic, Los Angeles, California, USA House Research Institute, Los Angeles, California, USA
J W House*
Affiliation:
House Clinic, Los Angeles, California, USA House Research Institute, Los Angeles, California, USA
F H Linthicum Jr
Affiliation:
House Research Institute, Los Angeles, California, USA
J L Go
Affiliation:
Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
*
Address for correspondence: Professor John W House, House Research Institute, 2100 West 3rd St, Los Angeles, CA 90057, USA E-mail: jhouse@hei.org
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Abstract

Background:

Petrous apex cholesterol granulomas are expansile, cystic lesions containing cholesterol crystals surrounded by foreign body giant cells, fibrous tissue reaction and chronic inflammation. Appropriate treatment relies on an accurate radiological diagnosis and an understanding of the distinguishing radiological features of relevant entities in the differential diagnosis of this condition.

Methods:

Firstly, this paper presents a pictorial review of the relevant radiological features of petrous apex cholesterol granuloma, and highlights unique features relevant to the differential diagnosis. Secondly, it reviews the histopathological and radiological findings associated with surgical drainage of these lesions.

Results:

Radiological features relevant to the differential diagnosis of petrous apex cholesterol granuloma are reviewed, together with radiological and histopathological features relevant to surgical management. Following surgical management, histopathological and radiological evidence demonstrates that the patency of the surgical drainage pathway is maintained.

Conclusion:

Accurate diagnosis of petrous apex cholesterol granuloma is essential in order to instigate appropriate treatment. Placement of a stent in the drainage pathway may help to maintain patency and decrease the likelihood of symptomatic recurrence.

Keywords

GranulomaOtologic Surgical ProceduresStentsPetrous ApicitisTemporal Bone
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 339 - 348
Copyright
Copyright © JLO (1984) Limited 2013

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Footnotes

Professor J W House was one of the JLO Visiting Professors for 2012

References

1Jackler, RK, Cho, M.A new theory to explain the genesis of petrous apex cholesterol granulomas. Otol Neurotol 2003;24:96–106CrossRefGoogle Scholar
2Mosnier, I, Cyna-Gorse, F, Grayeli, AB, Fraysse, B, Martin, C, Robier, A et al. Management of cholesterol granulomas of the petrous apex based on clinical and radiologic evaluation. Otol Neurotol 2002;23:522–8CrossRefGoogle ScholarPubMed
3Brackmann, DE, Toh, EH.Surgical management of petrous apex cholesterol granulomas. Otol Neurotol 2002;23:529–33CrossRefGoogle ScholarPubMed
4Sanna, M, Dispenza, F, Mathur, N, De Stefano, A, De Donato, G.Otoneurological management of petrous apex cholesterol granulomas. Am J Otolaryngol 2009;30:407–14CrossRefGoogle Scholar
5Kimura, R, Perlman, HB.Arterial obstruction of the labyrinth. Part I. Cochlear changes. Ann Otol Rhinol Laryngol 1958;67:5–40CrossRefGoogle Scholar
6Keithley, EM, Chen, M-C, Linthicum, F.Clinical diagnoses associated with histologic findings of fibrotic tissue and new bone in the inner ear. Laryngoscope 1998;108:87–91CrossRefGoogle ScholarPubMed