Cholesterol Granuloma

Cholesterol granuloma (CG) is a type of middle ear inflammation that can cause bleeding in the middle ear. Cholesterol granulomas are rare, benign cysts that can occur near temporal bone – a part of the skull next to the middle ear. There are no clear causes known for CG, however chronic ear infections or head trauma can lead to the condition. Cholesterol granuloma can be dangerous because of its proximity to the ear and several important nerves. If left untreated, CG can eventually cause facial numbness, bone depletion, severe headaches or hearing loss.



Symptoms are related to the size and location of the granuloma and may include:

  • Change in facial sensation (numbness, twitching or pain)
  • Double vision
  • Headaches
  • Hearing loss
  • Ringing in the ears (tinnitus)
  • Vertigo


If you have symptoms that may indicate Cholesterol Granuloma, diagnosis will begin by talking with your doctor about your symptoms and medical history. Your doctor will want to make a diagnosis with an otoscope (the familiar device used in a routine checkup) to look into your ears, and then develop a treatment plan for you. He or she may also perform magnetic resonance imaging (MRI) or computerized tomography (CT) scans of the head, which can help differentiate the granuloma from other types of lesions.

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Treatment Options

In cases where the granuloma is particularly large and destructive, surgical removal may be necessary. The surgical approach depends on the location of the cyst and status of your hearing. A preferred surgical treatment for Cholesterol Granuloma is the Endoscopic Endonasal Approach (EEA). Available at Aurora, this innovative minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach cysts without making an open incision. This approach prevents disfigurement, provides faster recovery time than with traditional surgery, and preserves hearing.

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