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Updated: Apr 7, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
[Preliminary experience on endoscopic endonasal management of petrous apex cholesterol granuloma]
Objective:
To explore the feasibility and related aspects on endoscopic endonasal management of petrous apex cholesterol granuloma.
Methods:
Retrospective data analysis was performed on 3 cases in which the endoscopic endonasal approach was used to manage this lesion between 2011 and 2014. Case information including radiological data, surgical technique, symptoms, and complications was reviewed.
Results:
The main clinical manifestations in these 3 patients were tinnitus, hearing loss at the hearing threshold of 40-50 dBHL. After operation, all 3 patients showed disappearance of their tinnitus and improvement of the hearing threshold of 10-30 dBHL (follow-up 6-45 months). Permanent drainage route was performed in 1 case which communicated with sphenoid sinus. While the other 2 cases which drained to pharyngeal recess resulted in drainage route blocking within the 3-6 months after surgery, but without obvious symptoms.
Conclusions:
This procedure for the drainage of petrous apex cholesterol granuloma showed to be effective, safe and minimally invasive. Although there is no recurrence in short-term, however, long-term surveillance and large case series are necessary, especially to the maitainence of permanent drainage.

