Cholesterol Granuloma of Temporal Bone: Our Experience

Objective: We would like to share our experience with four patients who were managed in our skull base unit in past 10 years.

Methods: Retrospective case note analysis of four patients with petrous apex cholesterol granuloma presenting from July 2006 till date. One patient had translabyrinthine approach drainage and other infracochlear approach as patient opted to for hearing preservation surgery. Three patients were managed conservatively as they continue to asymptomatic.

Conclusion: Although literature widely advocates different trans-temporal approaches, we achieved complete drainage by two different techniques, namely infracochlear and translabyrinthine. A trans-nasal approach through the sphenoid is also recommended. Position of carotid artery made transnasal approach challenging. We present review of this rare petrous apex pathology and share our experience with long-term follow-up, in which treatment options depends on patients symptoms, hearing level and site of the cyst.