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Paper Information

Title: 

ENDOSCOPIC ENDONASAL REMOVAL OF A HUGE EPIDERMOID OF PETROCLIVAL REGION WITH INTRADURAL INVASION

Type: PAPER
Author(s): JALESSI M.*,SHARIFI G.,FARHADI MOHAMMAD
 
 *
 
Name of Seminar: INTERNATIONAL CONNGRESS OF IRANIAN SOCIETY OF OTOLARYNGYOLOGY / HEAD AND NECK SURGERY
Type of Seminar:  CONGRESS
Sponsor: 
Date:  2010Volume 1
 
 
Abstract: 

BACKGROUND: EPIDERMOID TUMORS COMPRISE ONE PERCENT OF INTRACRANIAL TUMORS. WHEN THE TUMORS ARE INTRADURAL, THEY TYPICALLY OCCUR IN THE POSTERIOR FOSSA AT THE CEREBELLOPONTINE ANGLE. EXTRADURAL TUMORS ARE MOST OFTEN FOUND IN THE PETROUS BONE. EPIDERMOID TUMOR OF MIDLINE CLIVUS IS EVEN RARER. HUGE EXTRADURAL TUMORS WITH INTRADURAL INVASION DEMAND A WIDE APPROACH, PROPOSING A CHALLENGE FOR THE SURGEON.
CASE PRESENTATION: A CASE OF HUGE PETROCLIVAL LESION COMPLETELY REPLACING THE CLIVUS AND LEFT PETROUS APEX, EXTENDING FROM C1-C2 ARTICULATION INFERIORLY TO TUBERCULUM SELLA SUPERIORLY WAS PRESENTED. THE LATERAL EXTENSION OF THE TUMOR WAS THE STYLOID PROCESS AND IT HAD AN OBVIOUS INTRADURAL INVASION MEDIAL TO INTERNAL AUDITORY MEATUS PRODUCING AN INTRA-AXIAL MASS AT THE LEVEL OF UPPER PONES. THE PATIENT PRESENTED WITH ONE MONTH HEADACHE, NAUSEA, VERTIGO AND UNILATERAL TOTAL DEAFNESS. THE ENDOSCOPIC ENDONASAL APPROACH WAS CHOSEN AND USING IMAGE GUIDANCE, TOTAL TUMOR RESECTION WAS ACHIEVED. FOLLOWING THROUGH ITS DURAL DEFECT, THE INTRA-AXIAL PART OF THE TUMOR WAS ALSO SAFELY RESECTED AND THE DURAL DEFECT WAS SUCCESSFULLY REPAIRED.
CONCLUSION: THE ENDOSCOPIC ENDONASAL APPROACH ADJUNCT WITH IMAGE GUIDANCE AS A MINIMALLY INVASIVE APPROACH CAN PROVIDE A SAFE AND WIELD ACCESS TO THIS CHALLENGING REGION OBVIATING THE NEED FOR A DEMANDING AND SOPHISTICATED SURGERY.

 
Keyword(s): EPIDERMOID, INTRADURAL INVASION, PETROUS, CLIVUS, ENDOSCOPIC
 
 
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