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Endoscopic Cholesteatoma Surgery
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Extensive Cholesteatoma Compromising the Entire Ipsilateral Skull Base: Excision Through a Multi-Corridor Surgical
Lyubomir Rangachev1, Julian Rangachev1, Tzvetomir Marinov2
1Department of ENT, Medical University of Sofia, 1431 Sofia, Bulgaria.
Reports (MDPI)
|August 22, 2025
Summary
Extensive petrous bone cholesteatoma, a rare skull base tumor, was successfully removed using a combined endoscopic and surgical approach. This multi-corridor technique maximized tumor resection while preserving critical neurovascular structures.
Area of Science:
- Neurosurgery
- Skull Base Surgery
- Otolaryngology
Background:
- Petrous bone cholesteatoma is a rare, locally aggressive benign tumor.
- It presents diagnostic and therapeutic challenges due to potential for extensive destruction and complications.
Observation:
- A case of extensive petrous bone cholesteatoma involving the entire skull base is presented.
- The lesion extended from the petrous apex to the clivus, encasing the internal carotid artery and compressing the brainstem.
Findings:
- High-resolution CT and MRI were used for precise assessment of lesion extent and neurovascular relationships.
- A combined endoscopic transsphenoidal/transclival and retrolabyrinthine approach achieved gross total resection.
- Postoperative imaging confirmed successful tumor removal with no new neurological deficits.
Implications:
- This multi-corridor surgical approach is effective and safe for extensive skull base cholesteatomas.
- It allows for maximal tumor resection while minimizing risks to critical neurovascular structures.
