Cholesterol Granuloma Development following Temporal Bone Surgery

Otolaryngol Head Neck Surg. 2016 Jun;154(6):1115-20. doi: 10.1177/0194599816630954. Epub 2016 Mar 1.


Objective: To describe the clinical presentation and management of patients with cholesterol granulomas (CGs) that develop following temporal bone surgery.

Study design: Case series with chart review.

Setting: Two independent tertiary academic referral centers.

Subjects and methods: A multicenter retrospective review was performed to identify all patients between 2001 and 2014 who were diagnosed with a CG that developed following temporal bone surgery. Patients with a history of idiopathic petrous apex CGs were excluded, as were those with <6 months of follow-up after diagnosis. Demographic and clinical data were recorded at presentation, and the main outcome measure was symptom evolution over time.

Results: A total of 20 patients met inclusion criteria (median age, 55.0 years; 70.0% female), and their cases were analyzed. Diagnosis was made, on average, 149.5 months (median, 94.5; range, 13.0-480.0) following a temporal bone operation, which was for chronic ear disease in 75.0% of cases. The most common presenting symptoms were otalgia (55.0%) and otorrhea (40.0%). In patients initially managed with observation, 71.4% required no surgical intervention through a mean of 56.8 months (median, 30; range, 12.0-178.0) of follow-up. For those who initially underwent surgical excision, durable symptom relief was achieved in 66.7% of cases.

Conclusion: Postoperative CG formation in the temporal bone is a rare occurrence that can be encountered years following surgery. The present study suggests that conservative management can be appropriate for many cases in which patients are relatively asymptomatic.

Keywords: cholesterol granuloma; skull base; temporal bone; tympanomastoidectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Cholesterol*
  • Female
  • Granuloma / etiology*
  • Granuloma / therapy
  • Humans
  • Middle Aged
  • Otologic Surgical Procedures*
  • Postoperative Complications / etiology*
  • Postoperative Complications / therapy
  • Retrospective Studies
  • Temporal Bone / surgery*


  • Cholesterol