Endoscopic balloon dilation as an adjunct to extended endoscopic approaches to the skull base

Case report

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  • 1 Departments of Neurological Surgery,
  • 2 Otolaryngology—Head and Neck Surgery, and
  • 3 Neurology and Neuroscience, Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York
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Cholesterol granulomas (CGs) are benign, expanding cystic lesions surrounded by a thick fibrous capsule and filled with fluid, formed by the degradation of blood elements. The goal of surgery is to open the granuloma widely, creating a well-drained cavity. The endonasal endoscopic approach for this extradural lesion is a minimal access method for surgical removal or fenestration. The role of balloon dilation in creating a wide fenestration has not been previously described.

The authors describe a patient with a recurrent petrous apex CG who underwent an endoscopic, endonasal, transmaxillary transpterygoid approach to the petrous apex. A balloon sinuplasty catheter was used to dilate the surgical fenestration to maintain continued patency.

The authors report on their first experience using balloon dilation combined with endoscopic drainage of the petrous apex. The excellent surgical outcome of this minimally invasive technique holds promise for future endonasal approaches to the middle cranial fossa.

Abbreviation used in this paper:CG = cholesterol granuloma.

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Contributor Notes

Address correspondence to: Theodore H. Schwartz, M.D., Department of Neurological Surgery, Weill Cornell Medical College, 525 East 68th Street, Box #99, New York, New York 10065. email: schwarh@med.cornell.edu.

Please include this information when citing this paper: published online March 9, 2012; DOI: 10.3171/2012.2.JNS111815.

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