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  • Title: Endoscopy-assisted surgery with topical mitomycin for a cholesterol granuloma in the petrous apex.
    Author: Haginomori S, Mori A, Kanazawa A, Takenaka H.
    Journal: Laryngoscope; 2009 Dec; 119(12):2437-40. PubMed ID: 19780027.
    Abstract:
    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.
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