title: Cholesterol Granuloma Development following Temporal Bone Surgery.
abstract: To describe the clinical presentation and management of patients with cholesterol granulomas (CGs) that develop following temporal bone surgery.
  
  
  
  Case series with chart review.
  
  
  
  Two independent tertiary academic referral centers.
  
  
  
  A multicenter retrospective review was performed to identify all patients between 2001 and 2014 who were diagnosed with a CG that developed following temporal bone surgery. Patients with a history of idiopathic petrous apex CGs were excluded, as were those with <6 months of follow-up after diagnosis. Demographic and clinical data were recorded at presentation, and the main outcome measure was symptom evolution over time.
  
  
  
  A total of 20 patients met inclusion criteria (median age, 55.0 years; 70.0% female), and their cases were analyzed. Diagnosis was made, on average, 149.5 months (median, 94.5; range, 13.0-480.0) following a temporal bone operation, which was for chronic ear disease in 75.0% of cases. The most common presenting symptoms were otalgia (55.0%) and otorrhea (40.0%). In patients initially managed with observation, 71.4% required no surgical intervention through a mean of 56.8 months (median, 30; range, 12.0-178.0) of follow-up. For those who initially underwent surgical excision, durable symptom relief was achieved in 66.7% of cases.
  
  
  
  Postoperative CG formation in the temporal bone is a rare occurrence that can be encountered years following surgery. The present study suggests that conservative management can be appropriate for many cases in which patients are relatively asymptomatic.
authors.affiliation: Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA alex.sweeney@bcm.edu.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Sweeney
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: L Mariel
authors.initials: LM
authors.lastname: Osetinsky
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Jacob B
authors.initials: JB
authors.lastname: Hunter
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Carlson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002784:Cholesterol; D005260:Female; D006099:Granuloma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D013701:Temporal Bone / Q000601:surgery*
chemical_list: D002784:Cholesterol
keywords: cholesterol granuloma; skull base; temporal bone; tympanomastoidectomy