Differentiating Cholesterol Granuloma from Glomus Tumor: A Clinical Challenge

A cholesterol granuloma (CG) is a mass of cholesterol crystals surrounded by large foreign-body cells and chronic inflammation. Tympanic CG is a rare disease; in contrast, petrous bone CG is a more common ailment. Surgery is an elective treatment option for the majority of CGs. CG can be treated with a variety of surgical techniques; however, no case of primary endoscopic ear surgery has been reported to date. In the context of posttraumatic bleeding of the temporal bones, CGs can also occur. Surgical therapy for cholesteatomas and persistent otitis media frequently results in their unintentional discovery. The middle ear, mastoid bone, or petrous apex could all be affected by a CG. Cerebral granuloma near the petrous apex is linked to symptoms of bone erosion, including tinnitus, vertigo, sensorineural hearing loss, and injury to the cranial nerve. This middle-aged woman presented with a mass in the right middle ear cavity that was diagnosed as CG following surgical removal and histopathological examination.