Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2014
Minimally invasive image-guided access for drainage of petrous apex lesions: a case report.
Клинический случайСтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Balachandran Ramya, Tsai Betty S, Ramachandra Tara, Noble Jack H, Dawant Benoit M, Labadie Robert F, Bennett Marc L
Аннотация
OBJECTIVE: In this case report, we present a novel, minimally invasive image-guided approach to drainage of a petrous apex lesion.
PATIENT(S): A 34-year-old man diagnosed with a petrous apex lesion consistent with cholesterol granuloma. The granuloma was large and caused mild compression of the brainstem with associated neurologic symptoms and seizure-like activity.
INTERVENTIONS: Based on the anatomic location of the lesion, it was determined that the treatment plan would be to surgically drain the lesion via 2 linear paths-one after an infralabyrinthine approach and the other a subarcuate approach. Customized microstereotactic frames that mount on bone-implanted markers and constrain the drill along the desired path were used to accurately drill these desired paths and avoid damage to surrounding critical structures. After a simple mastoidectomy, the petrous apex was successfully reached without damage to vital adjacent structures by drilling the 2 linear channels using 2 custom microstereotactic frames.
MAIN OUTCOME MEASURES: Viscous brown liquid and debris was recovered by irrigating through one of the channels and suctioning through the other.
RESULTS: Drainage of the petrous apex was successfully performed via 2 linear channels without any complications. Custom microstereotactic frames were used to accurately drill those linear channels. Postoperative CT ensured no complications. Postoperative course of the patient was remarkable with normal hearing and normal facial nerve function.
CONCLUSION: We presented a successful implementation of an image-guided approach to drain petrous apex.
PATIENT(S): A 34-year-old man diagnosed with a petrous apex lesion consistent with cholesterol granuloma. The granuloma was large and caused mild compression of the brainstem with associated neurologic symptoms and seizure-like activity.
INTERVENTIONS: Based on the anatomic location of the lesion, it was determined that the treatment plan would be to surgically drain the lesion via 2 linear paths-one after an infralabyrinthine approach and the other a subarcuate approach. Customized microstereotactic frames that mount on bone-implanted markers and constrain the drill along the desired path were used to accurately drill these desired paths and avoid damage to surrounding critical structures. After a simple mastoidectomy, the petrous apex was successfully reached without damage to vital adjacent structures by drilling the 2 linear channels using 2 custom microstereotactic frames.
MAIN OUTCOME MEASURES: Viscous brown liquid and debris was recovered by irrigating through one of the channels and suctioning through the other.
RESULTS: Drainage of the petrous apex was successfully performed via 2 linear channels without any complications. Custom microstereotactic frames were used to accurately drill those linear channels. Postoperative CT ensured no complications. Postoperative course of the patient was remarkable with normal hearing and normal facial nerve function.
CONCLUSION: We presented a successful implementation of an image-guided approach to drain petrous apex.