Journal Information
Vol. 10. Issue 4.
Pages 313-323 (January 1999)
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Vol. 10. Issue 4.
Pages 313-323 (January 1999)
Granulomas de colesterol de punta de peñasco. A propósito de dos casos
Cholesterol granulomas of the petrous apex. A study of two cases
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S. Pardo, J. Molet, P. Parés, F. Bartumeus
Hospital de la Santa Creu i Sant Pau. Universidad autónoma de Barcelona. Barcelona
B. Oliver*, P. Tresserras*, M. Quer**, L. Colomo***
* Programa de cirugía de Base de cráneo. Universidad autónoma de Barcelona. Barcelona
** Servicio de Neurocirugía, ORL. Universidad autónoma de Barcelona. Barcelona
*** Anatomía Patológica. Universidad autónoma de Barcelona. Barcelona
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Resumen

El granuloma de colesterol de punta de peñasco (PP) se produce como consecuencia de una reacción inflamatoria por la presencia de cristales de colesterol. Este proceso es silente durante años. El diagnóstico se establece mediante la combinación de la TC y RM que permiten un adecuado diagnóstico diferencial de las lesiones de PP. Presentamos dos casos de granulomas de colesterol de PP extirpados completamente mediante abordaje preauricular infratemporal. Se revisa la literatura y se discuten la etiopatogenia y las características clínicas, histológicas, radiológicas y terapéuticas en estas lesiones. Nosotros pensamos que el abordaje preauricular infratemporal con exéresis completa de la tumoración seguido de la obliteración de la cavidad con grasa abdominal, es el procedimiento de elección para estas lesiones cuando la audición está conservada.

Palabras clave:
Abordaje preauricular infratemporal
Granuloma de colesterol
Hueso temporal
Punta de peñasco
Tumor de base de cráneo
Summary

Cholesterol granuloma of the petrous apex is an inflamatory granulation tissue response to the presence of cholesterol crystals. This lesion is silent for years. The diagnosis is made by the combination of CT and MRI (with and without paramagnetic contrast) that permits accurate differential diagnosis of primary petrous apex lesions. The authors present two patients with cholesterol granulomas of the petrous apex excised completely using a preauricular infratemporal approach. The literature is reviewed and the etiopatogenesis and the histological, clinical, radiographic and therapeutic features of these tumours are discussed. We believe that preauricular infratemporal approach with complete excision of the lesion followed by the obliteration of the cavity with abdominal fat is the procedure of choice when hearing is normal.

Key words:
Subtemporal-preauricular
Infratemporal approach
Cholesterol granuloma
Temporal bone
Petrous apex
Skull base tumors

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