RESUMEN
Labyrinthitis ossificans (LO) is a pathologic formation of fibrosis and new bone within the lumen of the otic capsule. The LO is a challenging issue in cochlear implantation since obliteration and obstruction of the cochlea make electrode insertion through scala tympani (classic route) difficult. Moreover, tympanomastoidectomy for resolution of chronic otitis media is also simultaneously considered for tympanogenic LO with severe to profound hearing loss because ossification could progress in case of staged or delayed implantation after initial tympanomastoidectomy. We report a patient with tympanogenic LO, who received subtotal petrosectomy with simultaneous cochlear implantation via scala vestibuli instead of the scala tympani for hearing rehabilitation.
Asunto(s)
Humanos , Cóclea , Implantación Coclear , Implantes Cocleares , Oído Interno , Electrodos , Fibrosis , Audición , Pérdida Auditiva , Laberintitis , Otitis Media , Rehabilitación , Rampa Timpánica , Escala VestibularRESUMEN
Among thyroid cancer patients, metastatic skull bone is rare, especially in the skull base region. The authors describe the case of a 42-year-old man with thyroid follicular carcinoma which metastasized to the left petrous bone. During the previous year, the patient had suffered from left tinnitus, hearing loss and peripheral facial nerve palsy; An CT and MRI scans demonstrated severe permeative bone destruction, as well as an enhancing soft tissue mass in the left petrous bone. Left carotid angiography revealed multiple feeding vessels, mainly via the occipital and superior laryngeal artery. The feeders were occluded by intra-arterial embolization with N-butylcyanoacrylate(NBCA). The patient underwent subtotal petrosectomy with near total removal of the tumor, followed by total thyroidectomy. He returned to work one month postoperatively and showed no evidence of recurrence during the follow-up period of seven months.