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Subtotal petrosectomy in selected advanced cholesteatoma cases

Presenting Author: Imre Gerlinger

Published online by Cambridge University Press:  03 June 2016

Imre Gerlinger  and
Imre Gerlinger
Imre Gerlinger
Affiliation:
Pécs University , Hungary
Imre Gerlinger
Affiliation:
Pécs Universtiy ENT Department
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Abstract

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Learning Objectives: Subtotal petrosectomy is the basic procedure in skull base surgery. It involves complete exenteration of all air cells of the temporal bone (middle ear and mastoid). It includes the following air tracts: retrosigmoid, retrofacial, antral, retrolabyrinthine, supralabyrinthine, infralabyrinthine, subpratubal and peritubal carotid cells. Only a few cells in the petrous apex left behind. The otic capsule is either removed or left behind. In advanced cholesteatoma cases, where numerous previous middle ear procedures could not reassure dry ear and when there is no possibility of hearing reconstruction and one whishes to attain a dry safe ear this procedure has proved to be the solution. Depending on the bone conduction result the procedure can be combined with the asimultaneous application of round window vibrant soundbridge or BAHA/Bonbridge implants. During the past years we carried out subtotal petrosectomies in 4 cases due to advanced cholesteatomas. The steps of the procedure will be demonstrated and conclusions will be drowed based on our experiences. Further rare indications of this useful procedure will be briefly discussed too.

Subtotal petrosectomy is the basic procedure in skull base surgery. It involves complete exenteration of all air cells of the temporal bone (middle ear and mastoid). It includes the following air tracts: retrosigmoid, retrofacial, antral, retrolabyrinthine, supralabyrinthine, infralabyrinthine, subpratubal and peritubal carotid cells. Only a few cells in the petrous apex left behind. The otic capsule is either removed or left behind.

In advanced cholesteatoma cases, where numerous previous middle ear procedures could not reassure dry ear and when there is no possibility of hearing reconstruction and one whishes to attain a dry safe ear this procedure has proved to be the solution. Depending on the bone conduction result the procedure can be combined with the simultaneous application of vibrant soundbridge in the round window or BAHA/Bonbridge implants. During the past years we carried out subtotal petrosectomies in 4 cases due to advanced cholesteatomas. The steps of the procedure will be demonstrated and conclusions will be drowned based on our experiences. Further rare indications of this useful procedure will be briefly discussed too.