CLINICAL CASES   

Otorinolaringologia 2002 June;52(2):67-71

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Congenital cholesteatoma of temporal bone. Surgical approach

Salami A. ¹, Dellepiane M. ¹, Spaziante R. ²

¹ Clinica ORL II 2 Clinica Neurochirurgia II Università degli Studi di Genova, Genova

The congenital cholesteatoma of the temporal bone is a rare tumor which can occur in children and adults. It differs from the acquired one which shows dendritic cells that develop during a chronic inflammatory disease. The aim of this study is to report a surgical approach to cholesteatoma of the rocca petrosa which, in presence of a deep earing loss or deafness, allows to get to the posterior fossa, through the cochlea, saving the posterior labyrinth. The surgical procedure consists in a retroaural incision, a wide mastoidectomy with antroatticotomy, drilling of promontory saving the posterior labyrinth and the facial nerve, in order to reach the endocranial portion of cholesteatoma. This technique is less invading when the cholesteatoma is in front of the acoustic facial package even if it is quite large (2-3 cm). The access is limited by the internal acoustic meatus at the back, by the internal carotid in the front side and by facial nerve at the bottom. The advantages of such a method are: presentation of the facial nerve and posterior labyrinth, easy approach, lack of labyrinthic crisis after operation, good surgical results. The disadvantages are: presence of deep earing loss or deafness and the lesion must be in front of the internal acoustic meatus.