Invasive middle ear cholesterol granuloma involving the basal turn of the cochlea with profound sensorineural hearing loss

Otol Neurotol. 2004 May;25(3):231-5. doi: 10.1097/00129492-200405000-00005.


Study design: A retrospective surgical case review.

Setting: A tertiary-care, university teaching hospital.

Patients: The authors describe a unique case operated on for a middle ear cholesterol granuloma, which had invaded the cochlea and vestibule causing profound sensorineural deafness.

Interventions: Extended radical mastoidectomy and labyrinthectomy with musculofascial seal.

Results: Successful postoperative outcome with no recurrence seen after 2 years of follow up.

Conclusion: To the authors' knowledge, this is the first reported case of a primary middle ear cholesterol granuloma with direct invasion into the cochlea. Such invasion of the otic capsule by cholesterol granulomas is rare and presents a diagnostic challenge to the attending otologist and radiologist. Salient points of the case history, pathogenesis, imaging studies, histopathology, and management are presented with a review of the current literature.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cholesterol*
  • Cochlea / pathology*
  • Ear, Middle / pathology*
  • Granuloma, Foreign-Body / complications
  • Granuloma, Foreign-Body / surgery*
  • Hearing Loss, Sensorineural / etiology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Otologic Surgical Procedures
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Vestibule, Labyrinth / pathology


  • Cholesterol