Facial Paralysis in a Patient With Cholesterol Cyst of the Petrous Bone

Abstract

Cholesterol cyst of the petrous bone is a distinct clinical entity causing bone destruction and compression of the surrounding neurovascular structures. Accurate diagnosis of the petrous bone lesions with CT and MRI is critical because optimal planning for the surgical approach is dependent upon the vital structures involved. In this report, we present a case with cholesterol cyst of the petrous bone extending to middle cranial fossa and presenting with facial paralysis. A 45-year-old man presented with left-sided facial paralysis of 2 months' duration with a history of treatment with steroids without benefit. The patient complained of a mild hearing loss with no previous otologic history. A complete otorhinolaryngologic examination revealed no abnormalities except left sided facial paralysis, indicating a score of VI, according to House and Brackman facial nerve grading scale. Cranial nerves II to VI were intact bilaterally, as was the remainder of the neurologic examination. http://www.entnet.org/journal/casereports/OTO-13.pdf/