title: Cholesterol granuloma of the middle ear invading the cochlea.
abstract: OBJECTIVE
  To report a second case of cholesterol granuloma of the middle ear invading the cochlea.
  
  
  METHODS
  A 54-year-old woman, who had undergone right-side tympanoplasty with stapedectomy, complained of intermittent right-side otorrhea associated with cophosis. Otomicroscopy found anterior eardrum perforation with mucopurulent effusion. Computed tomography (CT) showed a lesion filling the tympanic cavity, exposing the tympanic facial nerve, with destruction of the ossicles; the vestibule and cochlea were ossified except for the basal turn. The petrous apex was normal. Magnetic resonance imaging (MRI) showed invasion of the cavity and basal turn of the cochlea by a mass in heterogeneous hypersignal on T-1 weighted images, non-enhanced by gadolinium injection, and hyperintensity on T2-weighted images. Cholesterol granuloma of the middle ear was suspected, with surgery indicated due to the facial nerve exposure and cochlear invasion.
  
  
  RESULTS
  A brownish-yellow compressive mass invading the basal turn of the cochlea, suggestive of cholesterol granuloma, was removed. Histologic examination confirmed diagnosis.
  
  
  CONCLUSIONS
  Direct invasion of the otic capsule by cholesterol granuloma is extremely unusual. Surgery is indicated in such cases, to avoid onset of neurologic complications.
authors.affiliation: Service ORL et chirurgie cervico-faciale et plastique, hôpital Nord, CHU Saint-Étienne, Saint-Étienne cedex 2, France. christian.martin@chu-st-etienne.fr
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: M-B
authors.initials: MB
authors.lastname: Faye
authors.forename: P
authors.initials: P
authors.lastname: Bertholon
authors.forename: C
authors.initials: C
authors.lastname: Veyret
authors.forename: J-M
authors.initials: JM
authors.lastname: Dumollard
authors.forename: J-M
authors.initials: JM
authors.lastname: Prades
mesh_terms: D002784:Cholesterol; D015834:Cochlear Diseases / Q000209:etiology / Q000473:pathology; D004427:Ear Diseases / Q000150:complications* / Q000473:pathology*; D004432:Ear, Middle; D005260:Female; D006099:Granuloma / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008875:Middle Aged
chemical_list: D002784:Cholesterol