Temporal aneurysmal bone cyst: cost-effective method to achieve gross total resection

Abstract

Aneurysmal bone cyst (ABC) is a vascular benign bony expansile lesion. The treatment is gross total resection. Surgery for a skull base aneurysmal bone cyst poses a significant challenge because of its vascularity and the adjacent neurovascular structures. We present the case of a young male with a temporal aneurysmal bone cyst who underwent gross total resection of the lesion. The external carotid artery (ECA) was temporarily clamped to cut off the vascular supply. There was no intraoperative event, and the patient made a good postoperative clinical recovery. This technique was used as an alternative to subselective endovascular embolization of the ECA branches. This case represents a simple yet cost-effective surgical technique to control bleeding for a highly vascular lesion such as ABCs, especially in resource-deficient countries.

Aneurysmal bone cyst of the temporal bone presenting with reversible vestibular impairment

“…Radiotherapy is recommended for patients with residual or recurrent lesions post-operatively and deep skull base lesions; whether radiotherapy can induce sarcoma transformation still requires extensive clinical data to confirm. 19,20

Aneurysmal bone cyst involving the internal auditory canal is rare; petrous apex, squamous portions and mastoid are most commonly involved Temporal aneurysmal bone cyst manifestations include painless masses, headache, ear pain, tinnitus, hearing loss, facial paralysis, vertigo and otorrhoea Our patient presented with facial palsy, and loss of hearing and vestibular function, indicating damage to nerves running through internal auditory canal Vestibular function was restored post-operatively, which is uncommon Computed tomography and magnetic resonance imaging are often utilised in diagnosis, and histopathology is the confirmative examination Surgery is the ‘gold standard’ treatment

…”

Solid Variant of Aneurysmal Bone Cyst of the Temporal Bone

“…Should embolization prove cost-prohibitive, temporary intraoperative ECA occlusion has been shown to be less expensive and in certain instances an effective method for hemostasis in resource-poor settings. 23 When complete resection is not feasible, curettage resection can be employed but demonstrates a higher recurrence rate of 20%. 24 Also of note, Kumar et al 25 report a case of recurrent temporal ABC where targeted radiation therapy (30-36 Gy) proved effective in ameliorating symptoms and decreasing tumor bulk.…”