2025 Proffered Presentations
V093: INDOCYANINE GREEN ANGIOGRAPHY ASSISTED ENDONASAL MARSUPIALIZATION OF A PETROUS APEX CHOLESTEROL GRANULOMA
Wesley Shoap, MD1; Maximiliano Nunez, MD2; Ivan El-Sayed, MD3; Ezequiel Goldschmidt, MD, PhD4; 1LSU New Orleans Department of Neurosurgery; 2Stanford University School of Medicine Department of Neurosurgery; 3University of California San Francisco School of Medicine Department of Otorhinolaryngology; 4University of California San Francisco School of Medicine Department of Neurosurgery
A popular treatment for petrous apex cholesterol granulomas is endoscopic endonasal approach (EEA) for marsupialization of the cyst. The anteromedial triangle is a safe access window to the petrous apex via this corridor. We performed a vidian nerve-sparing EEA while utilizing high dose indocyanine green angiography for carotid localization and safe entry to the petrous apex. The patient’s cranial nerve palsy resolved immediately post-op and follow up evaluation demonstrated complete marsupialization of the cavity.