Endoscopic Transnasal and Transclival Resection of Cholesteatomas in the Clivus and Temporal Bone Pyramid: A Case Series of Eight Patients

TL;DR

This paper presents successful endoscopic surgery for removing cholesteatomas in eight patients, avoiding major brain surgery.

Contribution

The study demonstrates the effectiveness of endoscopic transnasal approaches for treating clival and temporal bone cholesteatomas.

Findings

Endoscopic transnasal surgery achieved near-total removal of cholesteatomas in all eight patients.

Only one patient experienced a complication (CSF leakage), indicating a generally safe procedure.

Abstract

Introduction

Cholesteatomas of the clivus and pyramids of the temporal bone can significantly reduce the quality of life of patients due to damage to the cranial nerves. The only effective method for their treatment is surgery.

Materials and methods

The study included a case series of eight patients: five females and three males. In all cases, the lesions were located within the clivus and pyramid of the temporal bone. All operations were performed using an endoscopic transnasal approach.

Results

In all cases, the patients underwent successful surgical treatment. Near-total removal (95%-99% of the neoplasm) was accomplished in all eight cases. Among complications, only postoperative cerebrospinal fluid (CSF) leakage was noted, which occurred in one (12.5%) patient.

Conclusions

Thanks to the development of endoscopic technologies, it has become possible to safely remove cholesteatomas of the clivus and pyramid without extensive trepanation and traumatic translabyrinthine approaches.

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