Medical Specialties

At the Center for Neurosciences, we work together across specialties to provide the best, most comprehensive approach to treatment.

Mucoceles of the Petrous Apex

Mucoceles are mucus-filled cysts that are typically located in the sinuses or mouth, but occasionally occur elsewhere in the body. Mucoceles of the petrous apex are extremely rare. The petrous apex is a pyramid shaped portion of the temporal bone located 3-4 centimeters deep to the ear. Expansile mucoceles occurring in this area can cause hearing loss, tinnitus, otorrhea (ear drainage), sensory abnormalities of the face, difficulty moving the eye on the affected side outward, facial weakness, headaches and dizziness.

The diagnosis of petrous apex mucocele is made after thorough microscope examination of the ears, comprehensive hearing tests and imaging studies, including CT of the temporal bones and MRI scans with internal auditory canal protocols. While watchful waiting may be an option for elderly or infirm patients, surgical drainage is recommended for most individuals because mucoceles expand with time. Expansion may erode vital structures of the temporal bones over time. Transmastoid and middle cranial fossa approaches are offered to patients based on the specific size and location of each lesion.

Why Choose Us

  • Dr. Abraham Jacob, Medical Director for Ear & Hearing (E&H) at the Center for Neurosciences (CNS), is fellowship trained in Otology, Neurotology, and Cranial Base Surgery. He is the first and most experienced Neurotologist recruited to Southern Arizona.
  • Dr. Jacob was a founding member of the University of Arizona (UA) Department of Otolaryngology prior to his departure and transition to CNS. At UA, he was Vice Chair of ENT and held the rank of full Professor with Tenure.
  • Dr. Jacob transitioned his practice to the Center for Neurosciences in early 2017 as he felt that the new environment helped to optimize delivery of personalized ear and lateral skull base care.
  • As a Neurotologist/Cranial Base Surgeon, Dr. Jacob is uniquely qualified in Tucson to surgically manage skull base mucoceles. His training and clinical expertise makes him the top choice in the region for both transmastoid and middle cranial fossa drainage procedures.