What is Cholesterol Granuloma?
Cholesterol granulomas are rare, benign (noncancerous) cysts that can occur at the tip of the petrous apex, a part of the skull that is next to the middle ear.
The cysts are expanding masses that contain fluids, lipids, and cholesterol crystals, surrounded by a fibrous lining.
Granulomas can occur throughout the body as a reaction to foreign material. They usually have no symptoms or serious effects.
However, cholesterol granulomas of the petrous apex are dangerous because of their proximity to the ear and several important nerves.
If left untreated and the mass continues to expand, cholesterol granulomas of the petrous apex can cause:
- Permanent hearing loss
- Nerve damage
- Bone destruction
Cholesterol granulomas can form when the air cells in the petrous apex are obstructed. The obstruction creates a vacuum that causes blood to be drawn into the air cells.
As red blood cells break down, cholesterol in the hemoglobin is released. The immune system reacts to the cholesterol as a foreign body, producing an inflammatory response.
Associated small blood vessels rupture as a result of the inflammation. Recurrent hemorrhaging makes the mass expand.
The surgical approach depends on the location of the cyst and the status of your hearing.
At UPMC, the preferred surgical treatment for cholesterol granulomas is the Endoscopic Endonasal Approach (EEA). This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access hard-to-reach or previously inoperable tumors and cysts. Benefits of EEA include:
- No incisions to heal
- No disfigurement
- Faster recovery time
