Cholesterol granulomas (CG) are benign cysts that grow in a special type of middle ear granulation tissue known as the petrous apex (located near the part of the skull that is next to the middle ear). This area is particularly prone to bleeding and can cause haemotypanum. Cholesterol granulomas contain fluids, lipids, and cholesterol crystals, surrounded by a fibrous lining. These cysts can grow anywhere throughout the body as they develop as a reaction for foreign material. Specifically, they are created with the air cells in the area are obstructed, causing a vacuum that draws blood into the air cells. The decomposition of blood releases cholesterol which triggers an inflammatory response. Middle aged individuals with a history of chronic otitis media are the most affected subgroup of patients that develop CG. One of the most common treatments for cholesterol granulomas is endoscopic endonasal approach (EEA).
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