Use of the pedicled nasoseptal flap in the endoscopic management of cholesterol granulomas of the petrous apex. Issue 8 (26th March 2015)

• Record Type: Journal Article
• Authors: Karligkiotis, Apostolos; Bignami, Maurizio; Terranova, Paola; Ciniglio‐Appiani, Mario; Shawkat, Abdulrahman; Verrilaud, Benjamin; Meloni, Francesco; Herman, Philippe; Castelnuovo, Paolo
• Is Part Of: International forum of allergy & rhinology. Volume 5:Issue 8(2015:Aug.)
• Page Start: 747
• Page End: 753
• Publication Date: 2015-03-26
• Subjects: 617.51005
• DOI: 10.1002/alr.21521
• Languages: English
• ISSNs: 2042-6976

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="alr21521-sec-0010" sec-type="section"> <title>Background</title> <p>Nowadays the endoscopic approach represents a useful alternative to traditional surgical approaches in the treatment of cholesterol granulomas (CGs) of the petrous apex (PA). Recently the nasoseptal flap (NSF) has been employed to permit long‐term patency of drainage site. The purpose of this study is to report our experience with the NSF in the endoscopic management of CG and to analyze the advantages, limitations, and outcomes of the technique.</p> </sec> <sec id="alr21521-sec-0020" sec-type="section"> <title>Methods</title> <p>A retrospective analysis was carried out on 10 patients affected by CG of the PA who had been treated endoscopically, using the NSF.</p> </sec> <sec id="alr21521-sec-0030" sec-type="section"> <title>Results</title> <p>An endoscopic transpterygoid approach was used for 6 patients and the remaining 4 were treated using the transclival approach. A NSF was used in all 10 cases. In 6 cases the flap was ipsilateral to the lesion whereas in 4 it was contralateral. In 90% of our patients no evidence of disease was observed after a mean follow‐up period of 35.7 months, with resolution of their symptoms. One patient presented a recurrence because of a technical error (inadequate placement of the flap in the cavity), and has been retreated endoscopically.</p> </sec> <sec id="alr21521-sec-0040" sec-type="section"> <title>Conclusion</title> <p>The pedicled NSF seems to be helpful in avoiding the concentric growth of the granulomatous cyst epithelium while assuring ventilation and drainage of the cyst. However, bigger studies with longer‐term follow‐up are needed to confirm these findings. Correct and meticulous placement of the flap inside the cystic cavity is the most critical issue for the success of the procedure.</p> </sec> </abstract>