PETROUS APEX CHOLESTEROL GRANULOMA - A NOVEL ENDOSCOPIC APPROACH

Cholesterol granuloma is a foreign body giant cell reaction to cholesterol deposits, with chronic inflammation, fibrosis, and vascular proliferation all contained within a fibrous capsule. Petrous apex lesions can be asymptomatic and discovered coincidentally on MRI. Non-neoplastic, primary cystic lesions of the apex more often present with headache, head pain, or aural pressure. Cholesterol granuloma is not only the most common cystic lesion of the petrous apex, it is also the only one that is invariably hyperintense on both T1 and T2-weighted images on MRI. This 35 year old male patient presented to our OPD with complaints of right ear discharge, hard of hearing and headache. He was diagnosed as a case chronic otitis media with cholesteatoma and petrous apex cholesterol granuloma. Complete endoscopic removal of cholesteatoma and cholesterol granuloma by infracochlear approach was done.