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

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.