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Role of endoscopy in lateral skull base approaches to the petrous apex

  • Otology
  • Published:
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Abstract

Objective

The aim of this article is to study the role and advantages of combined microscopic/endoscopic procedures or exclusive endoscopic approaches in the treatment of petrous apex pathologies.

Methods

The study was designed as a retrospective case series analysis. We included patients affected by pathologies of the petrous apex, who underwent microscopic/endoscopic-assisted or exclusive endoscopic procedures. Patient and pathology characteristics and surgical data (focusing on the involvement of the internal carotid artery (ICA) and facial nerve by the disease) were collected. Residual disease, detected through the endoscopic check, and the feasibility of endoscopic residual tumor removal were also evaluated. Finally, facial nerve and hearing functions were assessed pre- and postoperatively.

Results

The records of 75 patients undergoing lateral skull base surgery for petrous apex lesions, from May 2009 to March 2019, were collected. In 17 out of 75 patients, an exclusive endoscopic procedure was possible. The remaining 58 patients underwent a combined microscopic/endoscopic approach. In 15 cases, residual disease was found and removed endoscopically at the end of the microscopic procedure; in eight cases, the residual disease was medial and/or inferior to the horizontal segment of the ICA, while in two cases, it was located in the fundus of the internal auditory canal. In five cases, it involved the labyrinthine segment of the facial nerve.

Conclusion

Petrous apex surgery remains a traditional microscopic-based surgery, but the recent advent of endoscopic surgery has permitted an improvement in radicality minimizing the manipulation of neurovascular structures.

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Funding

This research was not funded.

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Authors and Affiliations

  1. Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy

    Daniele Marchioni, Luca Gazzini, Nicola Bisi & Alessia Rubini

  2. Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Modena, Italy

    Marco Bonali & Livio Presutti

Authors
  1. Daniele Marchioni
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  2. Luca Gazzini
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  3. Marco Bonali
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  4. Nicola Bisi
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  5. Livio Presutti
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  6. Alessia Rubini
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Corresponding author

Correspondence to Luca Gazzini.

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Conflict of interest

Authors have no conflict of interest to declare.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional (Comitato etico delle province di Verona e Rovigo) and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was collected from all the patients involved in the study.

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Marchioni, D., Gazzini, L., Bonali, M. et al. Role of endoscopy in lateral skull base approaches to the petrous apex. Eur Arch Otorhinolaryngol 277, 727–733 (2020). https://doi.org/10.1007/s00405-019-05750-9

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  • DOI: https://doi.org/10.1007/s00405-019-05750-9

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