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Arch Otolaryngol Head Neck Surg. 2006;132:1266-1267.

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Diagnosis: Bilateral petrous apex cephaloceles (PACs)

The T2-weighted image (Figure 1) revealed bilateral high-signal-intensity lesions in the region of Meckel caves, extending in a contiguous fashion into both petrous apices. These lesions followed the signal characteristics of cerebrospinal fluid on all imaging sequences and did not show any abnormal enhancement with gadolinium administration (Figure 2). The computed tomographic scan demonstrated smooth extrinsic scalloping of the left petrous apex but no osseous erosion or destruction (Figure 3). No expansion or scalloping was observed in the right petrous apex. A diagnosis of bilateral PACs was made.

The petrous apex shows variable degree of pneumatization; therefore, the spectrum of diseases involving this region range from inflammatory lesions developing within air cells (eg, mucoceles, cholesteatomas, and cholesterol granulomas) to more aggressive neoplastic lesions that primarily involve bone (eg, metastases and chondrosarcoma). Petrous apex cephaloceles, which are rare herniations of the posterolateral Meckel cave into the adjacent petrous apex, can be . . . [Full Text of this Article]

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Arch Otolaryngol Head Neck Surg. 2006;132(11):1265.
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