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Updated: Jun 20, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Endoscopy-assisted surgery with topical mitomycin for a cholesterol granuloma in the petrous apex
Shin-Ichi Haginomori1, Atsuko Mori, Atsuko Kanazawa
1Department of Otolaryngology, Osaka Medical College, Takatsuki, Japan.
Objectives/Hypothesis:
We present the case of a 21-year-old woman who underwent endoscopy-assisted surgery with topical mitomycin for a large cholesterol granuloma in the petrous apex that involved the eustachian tube.
Study Design:
Case report.
Methods:
Minimally invasive surgery was performed on the cholesterol granuloma with endoscopic assistance, and topical mitomycin (0.4 mg/mL) was administered to prevent scarring of the newly created drainage/ventilation route. With the endoscopic approach, the drainage/ventilation route was secured not only from the tympanic cavity, but also using a guidewire inserted from the pharyngeal orifice of the eustachian tube.
Results:
The drainage/ventilation route between the nasopharynx and middle ear cavity involving the cholesterol granuloma has been preserved more than for 9 months postoperatively. Her hearing has recovered.
Conclusions:
This less invasive technique is a surgical option for patients with a large cholesterol granuloma in the petrous apex involving the eustachian tube.
