The Case Report And Clinical Analysis Of Petrous Bone Cholesteatoma

Objective:To discuss the feasibility of otoendoscopy-assisted supralabyrinthine approach in the treatment of petrous bone cholesteatoma by clinical analysis of a case of petrous bone cholesteatoma(apex,V)and the review of related literatures,providing a new surgical reference for the treatment of petrous bone cholesteatoma,improving the awareness of doctor about the diagnosis,classification and surgical treatment of the disease.Methods:the clinical classification is acquired by clinical data of the case of petrous bone cholesteatoma.We try to apply the otoendoscopy-assisted supralabyrinthine approach to treat the case based on the patients of clinical classification,scope of lesions,endoscope multi-angle advantages and good lighting and amplification effect,and the experience of the domestic and external endoscopic surgical approach firstly.First,sufficient operating space was obtained in the superior tympanum to fully expose the inner wall of the tympanum.then,the most important is the removal the bone among the upper semicircular canal,semicircular canal and genicular ganglion to expose in the cranial fossa dura and expand the space of supralabyrinthine pathway fully.The endoscope was placed in this narrow area,and the cholesteatoma in the area was treated by angled surgical instrument.Results:the ear capsule structure and facial nerve was protected by otoendoscopyassisted supralabyrinthine approach,and craniotomy was avoided.The patient's facial function is House-Brckman facial nerve class ? after operation and bone conduction hearing has no evident difference compared with preoperative.No recurrence is found after 2 years of follow-up.Conclusion:1.It is a feasible surgical idea to treat a certain range of lateral skull base lesions through minimally invasive otoendoscopic approach,but the wide application of this surgical method in the lateral skull base requires the development of otoendoscopic technology and the improvement of surgical aspects.2.Cholesteatoma of the temporal bone is rare,and the clinician should improve the knowledge of the diagnosis and surgical route of this disease and avoid unnecessary complications.