Endoscopic transrostral- transsphenoidal approach to petrous apex cholesterol granuloma: case report

Cholesterol granuloma (CG) of the petrous apex is an inflammatory reaction to the by-products of eroded marrow cavities secondary to chronic obstruction of air cells within the petrous pyramid. We report a case of cholesterol granuloma in the left petrous bone occurring in a 28-year-old woman with an unusual presentation. The woman presented with a 6-month history of intermittent left hemicranial headache and diplopia. CT scan of petrous bone and skull base showed an expansile mass of the left petrous apex. For surgical removal we used the transrostral transsphenoid approach. After surgery, all the symptoms and signs of the patient completely recovered. In this report, the indications and merits of the endoscopic transsphenoidal drainage procedure are illustrated through a case presentation.