Diagnosis and treatment of cholesterol granuloma of the middle ear / 中国耳鼻咽喉头颈外科

ABSTRACT

OBJECTIVE To discuss the diagnosis and treatment of cholesterol granuloma of the middle ear and the choice and effect of surgical methods. METHODS A retrospective analysis was conducted on 18 cases of cholesterol granuloma of the middle ear confirmed by surgery and pathology. Different choices of surgical methods were made according to the lesion extension of this disease. RESULTS All patients were followed up for at least 6 months. Two cases with eustachian tube obstruction had ventilation tube inserted for a long time. One case who had recurrence and metastasis of nasopharyngeal carcinoma in the middle ear was transferred to oncology department for further treatment. Post-operative dry ears were obtained in the other cases whose pure tone thresholds were improved to different degrees. CONCLUSION Etiology of cholesterol granuloma of middle ear remains controversial. It's supposed to result from the bleeding, occlusion of ventilation and disturbance of drainage of the air cavity because of the middle ear inflammation, and bone marrow exposure. The middle ear and mastoid surgery can completely remove the disease tissues, and establish ventilation system of mastoid-tympani-eustachian, which is the key point of the middle ear surgery.