%0 Journal Article
%T Cholesterol granuloma presenting as a mass obstructing the external ear canal
%A Vasilios Nikolaidis
%A Hariklia Malliari
%A Dimosthenis Psifidis
%A Spyridon Metaxas
%J BMC Ear, Nose and Throat Disorders
%D 2010
%I BioMed Central
%R 10.1186/1472-6815-10-4
%X We report a case of a CG occupying the mastoid antrum and presenting as a mass into the EEC. Temporal bone computerized tomography showed a soft tissue mass which eroded the posterior-superior bony wall of the EEC. On magnetic resonance imaging, the mass revealed a high signal on both T1 and T2-weighted images. The CG was removed by a mastoidectomy procedure and the histopathologic report confirmed the diagnosis of CG. A type III tympanoplasty was performed.The postoperative course was uneventful.Cholesterol granuloma (CG), or cholesterol cyst, is a clinical entity that was first reported by Manasse in 1894 [1]. It appears as an expansible benign mass that contains brownish-yellow debris with cholesterol crystals and is characterized by slow growth. The lesion can be found in any part of the body where deposition of cholesterol crystals may occur though the temporal bone and specifically the petrous apex is the most common site [2,3]. This condition is more often recognized nowadays than in the past but this might reflects better diagnosis rather than an increase of incidence. However, CG presenting as a mass obstructing the external ear canal (EEC) is rare and it can be a diagnostic challenge. We were able to trace only three cases from the international literature [4-6]. We present our experience with a case of CG in the EEC and review the relevant medical literature.A 65 year old male presented to our ENT clinic as an outpatient for a routine yearly check up. He had a history of chronic otitis media with subtotal ear drum perforation in both ears. Left myringoplasty was performed thirty years ago. Otoscopic examination revealed stenosis of the right EEC due to the presence of a mass occupying the superior-posterior part of the canal, which prevented visualization of almost half of the perforated tympanic membrane (Figure 1). The middle ear had no signs of infection. Audiometry showed a moderate conductive hearing loss. The patient didn't detect any changes in his
%U http://www.biomedcentral.com/1472-6815/10/4