岩尖胆固醇肉芽肿的诊断和治疗

Diagnosis and treatment of petrous apex cholesterol granulomas.

目的 探讨岩尖胆固醇肉芽肿的诊断和手术治疗方法。方法 对６ 例经手术证实的病人进行回顾性分析。结果 ４ 例成熟胆固醇肉芽肿在 Ｔ１ 、 Ｔ２ 加权图像均为高信号，不增强或仅轻微周边增强，具有诊断价值。所有６ 例病人均获肉芽肿和囊壁全切除，并用带蒂颞肌或脂肪块消灭死腔，术后平均随访２ 年无复发。结论 要重视本病发病隐匿的特点，及时进行临床及影像学检查。扩大颞下入路适用于全切除病灶。

Objective To explore the diagnosis and surgical treament methods for petrous apex cholesterol granulomas. Methods Six patients with surgically confirmed petrous apex cholesterol granuloma were reviewed retrospectively.Results Four mature cholesterol granulomas demonstrated high signal intensities on both T 1 and T 2 weighted images, which, when combined with their lack of enhancement or only meager peripheral enhancement with gadolinium, were almost pathognomonic for this entity. All six patients underwent complete removal of the granuloma and cyst wall followed by oblity with a pedicled strip of temporalis muscle or fat fragments. No recurrences were seen at a mean follow up period of 2 years.Conclusions The concealed characteristics of petrous apex cholesterol granuloma required more careful and detailed clinical and imaging examinations. The extended subtemporal approach is helpful for radical resection of the lesion.