Abstract
We report a technique for postoperative management of a case of petrous apex cholesterol granuloma that had been operated upon using the transclival approach. The petrous apex was transclivally accessed at the initial surgery, a portion of the nasal septum mucosal flap was used to cover the cavity, and a T-shaped tube was placed in the petrous apex. A second surgery was performed because signs of obstruction were observed postoperatively at the petrous apex. In this procedure, the tube was removed, and one end of a small-caliber Nelaton catheter was sutured and fixed to the posterior nasal septal mucosa to allow it to be left securely in the petrous apex. The petrous apex was then washed through the catheter during the patient's outpatient visits following the procedure. No signs of obstruction in the opening were observed as of 4 years and 11 months after the second surgery. This case demonstrates that the placement of a tube to enabling washing of the petrous apex as well as subsequent postoperative care might be useful to prevent reobstruction after transclival surgery in patients with cholesterol granuloma of the petrous apex.
