The pterional approach for the surgical resection of an orbital cholesteatoma: a case report
Abstract Background Cholesteatomas are benign tumors mainly composed of cholesterol crystals that rarely arise within the orbit. However, orbital cholesteatomas require a complete surgical resection due to their recidivating potential. Transcranial approaches offering a broad surgical exposure of th...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-020-02579-3 |
| _version_ | 1818961538321481728 |
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| author | Parménides Guadarrama-Ortiz José Alberto Choreño-Parra Francisco Javier Pacheco-Sánchez Alberto Iván Rodríguez-Nava Gabriela García-Quintero Patricia Emilia Rodríguez-Muñoz Carlos Sánchez-Garibay Manuel Ángeles-Castellanos |
| author_facet | Parménides Guadarrama-Ortiz José Alberto Choreño-Parra Francisco Javier Pacheco-Sánchez Alberto Iván Rodríguez-Nava Gabriela García-Quintero Patricia Emilia Rodríguez-Muñoz Carlos Sánchez-Garibay Manuel Ángeles-Castellanos |
| author_sort | Parménides Guadarrama-Ortiz |
| collection | DOAJ |
| description | Abstract Background Cholesteatomas are benign tumors mainly composed of cholesterol crystals that rarely arise within the orbit. However, orbital cholesteatomas require a complete surgical resection due to their recidivating potential. Transcranial approaches offering a broad surgical exposure of the orbital cavity have been scarcely used for the management of these tumors. Here, we provide evidence of the benefits of the pterional craniotomy for the surgical resection of orbital tumors by sharing our experience in the surgical management of a cholesteatoma of the superotemporal orbital wall. Case presentation A 45-year-old Hispanic man with a 2-year history of progressive proptosis of the left eye attended to our center complaining of diplopia and migraine. At his arrival, physical examination revealed ptosis, palpebral edema, and exophthalmos of the left eye, as well as the abolishment of the ipsilateral photomotor and consensual responses. Fundoscopy showed mild optic atrophy, whereas a T2-weighted magnetic resonance imaging (MRI) of the head showed a hyperintense mass arising at the superotemporal wall of the orbit that was displacing the eyeball. The tumor was resected using a pterional craniotomy without postoperative complications. The histopathological analysis of the tumor revealed a cholesteatoma. The patient recovered the functionality of the left eye with no visual sensitive deficits nor tumor recurrence 1 year after the surgery. Conclusions Our results support the use of the pterional craniotomy as a safe procedure for the surgical resection of cholesteatomas arising at the superotemporal walls of the orbit, with low postoperative morbidity. |
| first_indexed | 2024-12-20T12:15:01Z |
| format | Article |
| id | doaj.art-7c82a275d1b9467db0d25df079872b35 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-20T12:15:01Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-7c82a275d1b9467db0d25df079872b352022-12-21T19:41:09ZengBMCJournal of Medical Case Reports1752-19472021-01-011511510.1186/s13256-020-02579-3The pterional approach for the surgical resection of an orbital cholesteatoma: a case reportParménides Guadarrama-Ortiz0José Alberto Choreño-Parra1Francisco Javier Pacheco-Sánchez2Alberto Iván Rodríguez-Nava3Gabriela García-Quintero4Patricia Emilia Rodríguez-Muñoz5Carlos Sánchez-Garibay6Manuel Ángeles-Castellanos7Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Centro Especializado en Neurocirugía y Neurociencias Mexico (CENNM)Departamento de Neuropatología, Instituto Nacional de Neurología y Neurocirugía “Manuel Velasco Suárez”Departamento de Anatomía, Facultad de Medicina, Universidad Nacional Autónoma de MéxicoAbstract Background Cholesteatomas are benign tumors mainly composed of cholesterol crystals that rarely arise within the orbit. However, orbital cholesteatomas require a complete surgical resection due to their recidivating potential. Transcranial approaches offering a broad surgical exposure of the orbital cavity have been scarcely used for the management of these tumors. Here, we provide evidence of the benefits of the pterional craniotomy for the surgical resection of orbital tumors by sharing our experience in the surgical management of a cholesteatoma of the superotemporal orbital wall. Case presentation A 45-year-old Hispanic man with a 2-year history of progressive proptosis of the left eye attended to our center complaining of diplopia and migraine. At his arrival, physical examination revealed ptosis, palpebral edema, and exophthalmos of the left eye, as well as the abolishment of the ipsilateral photomotor and consensual responses. Fundoscopy showed mild optic atrophy, whereas a T2-weighted magnetic resonance imaging (MRI) of the head showed a hyperintense mass arising at the superotemporal wall of the orbit that was displacing the eyeball. The tumor was resected using a pterional craniotomy without postoperative complications. The histopathological analysis of the tumor revealed a cholesteatoma. The patient recovered the functionality of the left eye with no visual sensitive deficits nor tumor recurrence 1 year after the surgery. Conclusions Our results support the use of the pterional craniotomy as a safe procedure for the surgical resection of cholesteatomas arising at the superotemporal walls of the orbit, with low postoperative morbidity.https://doi.org/10.1186/s13256-020-02579-3Orbital tumorsCholesteatomaCholesterol granulomaPterional approachOcular surgeryNeurosurgery |
| spellingShingle | Parménides Guadarrama-Ortiz José Alberto Choreño-Parra Francisco Javier Pacheco-Sánchez Alberto Iván Rodríguez-Nava Gabriela García-Quintero Patricia Emilia Rodríguez-Muñoz Carlos Sánchez-Garibay Manuel Ángeles-Castellanos The pterional approach for the surgical resection of an orbital cholesteatoma: a case report Journal of Medical Case Reports Orbital tumors Cholesteatoma Cholesterol granuloma Pterional approach Ocular surgery Neurosurgery |
| title | The pterional approach for the surgical resection of an orbital cholesteatoma: a case report |
| title_full | The pterional approach for the surgical resection of an orbital cholesteatoma: a case report |
| title_fullStr | The pterional approach for the surgical resection of an orbital cholesteatoma: a case report |
| title_full_unstemmed | The pterional approach for the surgical resection of an orbital cholesteatoma: a case report |
| title_short | The pterional approach for the surgical resection of an orbital cholesteatoma: a case report |
| title_sort | pterional approach for the surgical resection of an orbital cholesteatoma a case report |
| topic | Orbital tumors Cholesteatoma Cholesterol granuloma Pterional approach Ocular surgery Neurosurgery |
| url | https://doi.org/10.1186/s13256-020-02579-3 |
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