Abstract

Cholesterol granuloma is an unusual lesion of temporal bone and may develop in any portion of the pneumatic system. Proposed factors in the pathophysiology of cholesterol granuloma include hemorrhage, interference with drainage, and inadequate aeration. Cholesterol granuloma is commonly encountered in the middle ear and sclerotic mastoid during chronic otitis media operation. In sclerotic mastoid, cholesterol granuloma usuallly restricted to a small lesion without destruction of the surrounding structure. Without chronic otitis media and previous otologic operation history, it was reported rarely in pneumatic petrous apex and extremely rarely in mastoid and external auditory canal. In this case, the pneumatic bone can be destroyed by expansile mass. A 9-year-old female patient came to ENT clinic with progressive hearing loss for 9 months. The external auditory canal was obstructed with bulging mass from posterior canal wall. Cholesterol granuloma was destroying mastoid cavity and posterior canal wall without any other otologic diseases. Destroyed posterior canal wall was reconstructed with a piece of conchal cartilage. (J Clinical Otolaryngol 2000;11:330-334)

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