Objective : The progressions of endoscopic technology and the increased understanding of skull base anatomy make the endonasal approach possible. We report a case of mucocele in the left petrous apex who underwent the endoscopic endonasal approach. Case presentation : A 35-year old man presented with the diplopia from 6 months ago. The 6 th nerve palsy was found on the neurologic examination. Magnetic resonance(MR) images showed a non-enhancing cystic mass in left petrous apex. The mass eroded the petrous apex sharply. Endoscopic endonasal approaches was performed and pathologic examination revealed the mucocele. The patient’s neurologic deficit was recovered completely after surgery. Conclusion : The endoscopic endonasal approach to the petrous apex lesions is safe and effective for appropriately selected patients in the hands of experienced endoscopic skull base surgeons. This approach offers advantages of removing the hearing and facial nerve risks from the transtemporal or transcranial approach.
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