CT venography

Use in selecting a surgical approach for the treatment of petrous apex cholesterol granulomas

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2 Citations (Scopus)

Abstract

OBJECTIVE: To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. INTERVENTION(S): Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. MAIN OUTCOME MEASURE(S): Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. RESULTS: Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. CONCLUSION: Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.

Original languageEnglish (US)
Pages (from-to)386-391
Number of pages6
JournalOtology and Neurotology
Volume30
Issue number3
DOIs
StatePublished - Apr 2009

Fingerprint

Phlebography
Granuloma
Neck
Cholesterol
Cochlea
Carotid Arteries
Therapeutics
Drainage
Bone and Bones
Temporal Bone
Tertiary Care Centers
Magnetic Resonance Imaging

Keywords

  • Angiography
  • Cholesterol granuloma
  • Petrous apex
  • Radiology

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Clinical Neurology
  • Sensory Systems
  • Medicine(all)

Cite this

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title = "CT venography: Use in selecting a surgical approach for the treatment of petrous apex cholesterol granulomas",
abstract = "OBJECTIVE: To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. INTERVENTION(S): Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. MAIN OUTCOME MEASURE(S): Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. RESULTS: Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. CONCLUSION: Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.",
keywords = "Angiography, Cholesterol granuloma, Petrous apex, Radiology",
author = "Brandon Isaacson and Kutz, {Joe Walter} and Dianne Mendelsohn and Roland, {Peter S.}",
year = "2009",
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doi = "10.1097/MAO.0b013e31819d3355",
language = "English (US)",
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pages = "386--391",
journal = "Otology and Neurotology",
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T1 - CT venography

T2 - Use in selecting a surgical approach for the treatment of petrous apex cholesterol granulomas

AU - Isaacson, Brandon

AU - Kutz, Joe Walter

AU - Mendelsohn, Dianne

AU - Roland, Peter S.

PY - 2009/4

Y1 - 2009/4

N2 - OBJECTIVE: To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. INTERVENTION(S): Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. MAIN OUTCOME MEASURE(S): Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. RESULTS: Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. CONCLUSION: Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.

AB - OBJECTIVE: To demonstrate the use of computed tomographic (CT) venography in selecting a surgical approach for cholesterol granulomas. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Three patients presented with symptomatic petrous apex cholesterol granulomas with extensive bone erosion involving the jugular fossa. INTERVENTION(S): Computed tomographic venography was performed on each patient before selecting a surgical approach for drainage. MAIN OUTCOME MEASURE(S): Localization of the jugular bulb in relation to the petrous carotid artery and basal turn of the cochlea was ascertained in each subject. RESULTS: Three patients with large symptomatic cholesterol granulomas were identified. Conventional CT demonstrated extensive bone erosion involving the jugular fossa in each patient. The location of the jugular bulb and its proximity to the petrous carotid artery and basal turn of the cochlea could not be determined with conventional temporal bone CT and magnetic resonance imaging. Computed tomographic venography provided the exact location of the jugular bulb in all 3 patients. The favorable position of the jugular bulb in all 3 cases permitted drainage of these lesions using an infracochlear approach. CONCLUSION: Computed tomographic venography provided invaluable information in 3 patients with large symptomatic cholesterol granulomas. All 3 patients were previously thought to be unsuitable candidates for an infracochlear or infralabyrinthine approach because of the unknown location of the jugular bulb.

KW - Angiography

KW - Cholesterol granuloma

KW - Petrous apex

KW - Radiology

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