Discussion Author(s): P. G. Michaelson
Cholesterol granuloma of the petrous apex is believed to result from chronic obstruction of the air cells of the petrous apex and subsequent inflammation (1,2). Obstruction of the air cells, which normally communicate with the middle ear, is usually the result of chronic disease such as chronic otitis media. The inflammatory process is believed to involve recurrent bleeding into the obstructed air cells. Products of blood degradation, including cholesterol crystals, form a slowly expansile, fluid-filled lesion.
Presenting signs and symptoms of this disease relate to the anatomic position of the granuloma. Petrous apex granulomas usually present with cranial nerve compression; cranial nerves V though VIII may be involved (4). Headache, diplopia, hearing loss, vertigo and facial nerve weakness or spasm may be present.
The characteristic appearance of a cholesterol granuloma of the petrous apex on CT is as an expansile soft-tissue mass in the petrous apex. On MR, the lesion does not enhance and has high signal on both T1WI and T2WI. The high TIWI signal is believed to be the result of blood products, and helps to differentiate the lesion from a cholesteatoma or a neoplasm.
Surgical treatment of the cholesterol granuloma is achieved by drainage. Re-establishment of air exchange prevents recurrence of the lesion (4).
Topic Details: Cholesterol granuloma :: :: Search for other Topics with Cholesterol granuloma
Highlight this =>[ Cholesterol granuloma ]<= for a Popup Search Tool
-2 :: Case - 11745 :: 
Print :: :: :: 
:: :: :: ::