Cholesterol granuloma presenting with facial nerve paralysis following translabyrinthine surgery: A case report.
BACKGROUND
Cholesterol granuloma (CG) is a foreign body giant cell inflammatory reaction to blood degradation products, and clinically presents as a cyst with a thick fibrous lining filled with brownish-yellow fluid. We report an unusual case of CG with facial nerve paralysis 9 years after translabyrinthine (TL) surgery for vestibular schwannoma (VS) removal.


METHODS
A 70-year-old woman, who underwent TL surgery previously, presented with left facial palsy (FP). CT findings revealed devastated cochlea and uncovered facial nerve, and progression of FP up to House-Brackmann grade 6 was observed. Therefore, we suspected recurrence of cystic VS or facial schwannoma, although MRI was inconsistent with that of schwannoma. The cyst was completely surgically excised, and histopathology confirmed CG diagnosis. Postoperatively her facial movement improved to grade 4. Recurrence has not been encountered since 7 years.


CONCLUSIONS
During follow-up after TL surgery for VS, care should be taken for possibility of CG occurring.
Department of Otolaryngology, Tokai University, School of Medicine, Isehara, Japan.
Kyoko
K
Odagiri
Department of Otolaryngology, Tokai University, School of Medicine, Isehara, Japan. Electronic address: mhamada@is.icc.u-tokai.ac.jp.
Masashi
M
Hamada
Department of Otolaryngology, Tokai University, School of Medicine, Isehara, Japan.
Masahiro
M
Iida
D000368:Aged; D002784:Cholesterol; D005155:Facial Nerve Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000601:surgery*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed
D002784:Cholesterol
Facial palsy; Temporal bone; Vestibular schwannoma