Modified Translabyrinthine Approach for Massive Petrous Bone Cholesteatoma Removal and Cochlear Preservation Using Latent Spaces Anterior to the Cochlea
| Autor: | Chunfu Dai, Ya-sheng Yuan, Zhao-jun Qin, Fang-Lu Chi, Zhen Gao, Wei-Dong Zhao, Wen-long Tang |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Microsurgery Endoscope medicine.medical_treatment Neurosurgical Procedures Petrous bone otorhinolaryngologic diseases medicine Humans Cochlear implantation Cholesteatoma Cochlea Translabyrinthine approach Petrous Apex business.industry medicine.disease Surgery Female sense organs Neurology (clinical) business Organ Sparing Treatments Petrous Bone |
| Zdroj: | World neurosurgery. 143 |
| ISSN: | 1878-8769 |
| Popis: | Objective Microsurgery is the reference standard treatment of petrous bone cholesteatoma (PBC). In most cases, radical removal of an extensive PBC can only be achieved at the cost of sacrificing the cochlea. Such treatment will result in the impossibility of future cochlear implantation for hearing rehabilitation purposes. To address this issue, a modification of the traditional translabyrinthine (TL) approach with endoscopic assistance has been developed for radical removal of extensive PBC with preservation of the cochlea. Methods From June 2017 to December 2017, 3 patients with a massive PBC underwent surgical removal using the modified TL approach by the senior author in our department. We reviewed the patient characteristics and retrospectively studied the surgical outcomes and postoperative complications. In the present report, we have described our modified TL approach in detail. Results Complete resection of the PBC and successful cochlea preservation were achieved in all 3 patients. No recurrence had developed during the follow-up period. However, various degrees of cochlear ossification were observed in 2 patients postoperatively. Conclusions This modified TL approach provides the possibility of fully exposing the whole petrous apex without removing the cochlea in selected cases. However, the development of long-term cochlear ossification requires further investigation to allow for successful cochlear implantation. |
| Databáze: | OpenAIRE |
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