| For medical practitioners and the general public - Cholesterol Journal Article Catalog. |
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| Cholesterol granuloma of the maxillary sinus Leon, M. E., C. Chavez, et al. (2002), Arch Pathol Lab Med 126(2): 217-9. Abstract: Cholesterol granuloma is usually associated with chronic middle ear disease and is common in the mastoid antrum and air cells of the temporal bone. It has also been reported in other parts of the skull, such as the frontal and maxillary sinuses and orbit. Cholesterol granuloma is rare in the paranasal sinuses. We report a new case of cholesterol granuloma in the maxillary sinus of a 38-year-old man who underwent surgical excision. We also review the literature and discuss the mechanism of development for this lesion. The resected specimen showed fragments of respiratory mucosa with cholesterol clefts surrounded by multinucleated foreign-body giant cells. Some multinucleated foreign-body giant cells showed asteroid bodies. Hemorrhagic areas, hemosiderin-laden macrophages, chronic inflammatory cells, and dilated lymphatics vessels were seen as well. Increased intrasinus pressure due to drainage obstruction may affect venous and lymphatic drainage from the sinus cavity, leading to venule microhemorrhages while still allowing arterial blood into the sinus mucosa and further contributing to a large localized hemorrhage. Lymphatic drainage may be insufficient to completely remove the lipid components of the red blood cells, and the lipid accumulation may contribute to the formation of cholesterol crystals and their esters. |
| Cholesterol granuloma of the maxillary sinus. A case report Dilek, F. H., M. Kiris, et al. (1997), Rhinology 35(3): 140-1. |
| Cholesterol granuloma of the maxillary sinus: 2 cases report Xu, W. and X. Jin (1998), Lin Chuang Er Bi Yan Hou Ke Za Zhi 12(12): 549-51. Abstract: The paper firstly represents two cases of cholesterol granuloma of the maxillary sinus in China. The common symptoms of the disease include nasal obstruction and bone erosion in severe case. The disease is related to obstruction of the antral ostia, hemorrhage into polypoidal mucosal disease or cholesterol precipitation in the walls of antral cyst. A review of the literature on cholesterol granuloma suggests that poor ventilation in a closed space and long-standing inflammation with effusion or hemorrhage contribute to the formation of cholesterol granuloma. Long-lasting cure is achieved by radical maxillary sinusotomy which is the main therapeutic means. |
| Cholesterol granuloma of the maxillary sinus: six cases from the same region Kunt, T., S. Ozturkcan, et al. (1998), J Laryngol Otol 112(1): 65-8. Abstract: It is common to find cholesterol granuloma in the mastoid antrum and air cells of the temporal bone, but it is very rare in paranasal sinuses. In the development of this pathology, the key factor is the presence of a closed cavity containing exudate and blood. Six cases of cholesterol granuloma of the maxillary sinus are presented from six years' study in our hospital. According to the main symptoms, clinical findings, and radiological appearance (except the destruction of the antrum wall in some patients), the pathology was similar to chronic maxillary sinusitis. All the patients were treated with radical operative techniques. In this study, we reviewed the literature and our cases, and could not detect any findings to explain why this pathology had occurred frequently in our district. We strongly recommend that investigations should be carried out on all specimens obtained from paranasal sinus surgery, because the cholesterol granuloma in the maxillary antrum could be mistaken for chronic sinusitis. |
| Cholesterol granuloma of the middle ear: cause of idiopathic hemotympanum Plaza, G., J. Alvarez-Linera, et al. (2000), Acta Otorrinolaringol Esp 51(8): 724-8. Abstract: We report a case of a 49-year-old man with a cholesterol granuloma of the middle ear in an only hearing ear. As it mimicked a vascular middle ear tumor, a contrast cranial computed tomography and a gadolinium-enhanced-magnetic resonance imaging with vascular reconstructions were performed, confirming that both carotid artery and jugular vein were near the lesion but not involved. This patient could be managed with a conservative hearing preserving approach. Differential diagnosis of vascular middle ear anomalies is reviewed, specially in relation to cholesterol granulomas as a cause of idiopathic hemotympanum. |
| Cholesterol granuloma of the middle ear: report of 5 cases Campos, A., M. Armengot, et al. (1996), Acta Otorhinolaryngol Belg 50(2): 125-9. Abstract: Cholesterol granulomas of the middle ear (CGME) constitute a focal inflammatory response with foreign body giant cells mobilized against the presence of cholesterol crystals. The air spaces within the temporal bone are commonly affected, especially in association with chronic disease of the middle ear involving diminished ventilation. The aim of this paper is to review 5 cases of CGME. The authors intend to establish the etiology of CGME and its likely relationship with other common middle ear diseases. |
| Cholesterol granuloma of the orbit--pathogenesis and surgical management Loeffler, K. U. and G. Kommerell (1997), Int Ophthalmol 21(2): 93-8. Abstract: BACKGROUND: Cholesterol granuloma of the orbit is a rare entity, and its pathogenesis is still poorly understood. We report on 6 cases including one patient who had been examined by X-ray prior to the tumor's clinical manifestation. PATIENT DATA: All tumors were located in the superior temporal orbit. Histologically, they revealed the typical features of a cholesterol granuloma without any epithelial elements. They infiltrated the bone but left the soft tissues largely intact. Complete surgical removal of the granulomatous mass was attempted in each case, and particular attention was given to thorough abrasion of the bone. Only 2 patients reported a previous trauma. In one of them, retrospective evaluation of the X-ray scan taken a few hours after his accident revealed no definite changes in the orbital bone at the site of the future tumor. The only recurrence developed in a patient in whom the bony base of the tumor had not been drilled out completely. CONCLUSIONS: The origin of orbital cholesterol granuloma remains unknown. According to our data and those available in the literature, trauma is not a precondition but may accelerate growth. Some non-epithelial malformation in the bone, with a predelection in the temporal upper quadrant, might be the origin. To prevent a recurrence it appears essential to totally erase the tumor from its bony bed. |
| Cholesterol granuloma of the peritoneum al-Amer, A. F., H. S. Walia, et al. (1990), Can J Surg 33(5): 410-3. Abstract: Cholesterol granulomas are common in the mastoid region but have rarely been reported in other areas. The authors report the case of a 40-year-old man who had a cholesterol granuloma of the peritoneum. They discuss the morphology of the condition and the difficulties of diagnosis. It is likely that chronic or recurrent inflammation plays a major role in the pathogenesis and that, when dealing with such lesions preoperatively or intraoperatively, a radical approach may not be necessary. |
| Cholesterol granuloma of the petrous apex Clifton, A. G., P. D. Phelps, et al. (1990), Br J Radiol 63(753): 724-6. |
| Cholesterol granuloma of the petrous apex Hunt, J. P., E. Palacios, et al. (2002), Ear Nose Throat J 81(4): 217-8. |
| Cholesterol granuloma of the petrous apex Morales Angulo, C., A. del Valle Zapico, et al. (1994), Acta Otorrinolaringol Esp 45(3): 203-5. Abstract: Cholesterol granuloma of the petrous apex is an inflammatory granulation tissue response to the presence of cholesterol crystals. It is not generally associated with middle-ear pathology. CT and MRI are fundamental for diagnosis. MRI is more specific and shows a well-circunscribed mass with high signal intensity on both T1 and T2 weighted images. We present a case of cholesterol granuloma of the petrous apex that was previously diagnosed as cholesteatoma. We emphasize the importance of preoperatory differentiation of the lesion from cholesteatoma. Cholesterol granuloma does not require full excision of the lesion. Drainage and permanent aeration is usually sufficient. |
| Cholesterol granuloma of the petrous apex with peritubal extension Verellen, S., M. Horvath, et al. (1992), Rofo 157(1): 93-4. |
| Cholesterol granuloma of the petrous apex. A post mortem study on temporal bones Salvinelli, F., F. Greco, et al. (1999), Eur Rev Med Pharmacol Sci 3(3): 135-8. Abstract: Otitis media (OM) is an infection localized in the middle ear: mastoid, middle ear cavity, Eustachian tube. The classification of OM includes otitis media with effusion, otitis media without effusion, and chronic otitis media. A rare complication of chronic otitis is cholesterol granuloma of the petrous apex. It may develop in any aerated portion of the temporal bone but most commonly develops when a pathologic process obstruct the air cell tracts to the petrous apex preventing normal aeration. |
| Cholesterol granuloma of the petrous apex: establishment of a drainage route into the superior tympanic cavity--technical note Kamiguchi, H., T. Kawase, et al. (1996), Neurol Med Chir (Tokyo) 36(9): 662-5. Abstract: A 40-year-old male presented with a cholesterol granuloma of the petrous apex manifesting as progressive hearing loss and tinnitus. The lesion was treated via an extradural middle cranial fossa approach employing a new procedure to establish a drainage pathway into the superior tympanic cavity which preserved his hearing. The pathway was formed by a groove 5 mm wide and deep in the anterolateral aspect of the petrous bone, crossing the major petrosal nerve and carotid artery, running around the cochlea, crossing the tensor tympanic muscle, and entering the superior tympanic cavity above the orifice of the eustachian tube. This procedure is easy to perform without special techniques. |
| Cholesterol granuloma of the petrous apex--etiology, diagnosis and therapy Lorenz, K. J., G. Hamer, et al. (1996), Laryngorhinootologie 75(12): 775-82. Abstract: BACKGROUND: In the past cholesterol granuloma has been described as an innocuous disease in the mastoid air cells related to an obstruction of the air source to a normally pneumatized cavity due to chronic inflammation. Cholesterol granuloma of the petrous apex has since been recognized as a distinct clinical entity that may cause severe cranial nerve problems and which thus demands adequate surgical treatment. CASE REPORT: Diagnosis and surgical management are discussed on the basis of two typical case studies and a review of the literature. |
| Cholesterol granuloma of the petrous tip: a by CT and MRI reliably identifiable lesion Kirschsieper, B. and E. C. Kirsch (2001), Rofo 173(7): 672-3. |
| Cholesterol granuloma of the temporal bone: a pathologic designation or a clinical diagnosis? Rinaldo, A., A. Ferlito, et al. (2005), Acta Otolaryngol 125(1): 86-90. |
| Cholesterol granuloma of the temporal lobe Morais, D., J. Diaz de Tuesta, et al. (1996), Acta Otorrinolaringol Esp 47(4): 317-20. Abstract: Cholesterol granuloma is a histological term used to describe a non-specific inflammatory reaction produced by the presence of cholesterol crystals, which may originate a foreign-body reaction. Cholesterol granuloma of the temporal bone is silent for years and not preceded by a history of otitis media. The diagnosis is made by CT and MRI, which reveal an expansive, isodense lesion brain tissue and increased signal intensity on both T1 and T2-weighted images respectively. A case of cholesterol granuloma of the petrous apex is presented. The granuloma was excised completely using an infra-retrolabyrinthine approach. |
| Cholesterol granuloma of the tunica vaginalis mimicking a neoplasm Nativ, O., Y. Mor, et al. (1995), Isr J Med Sci 31(4): 235-6. |
| Cholesterol granuloma presenting in the ear canal Matt, B. H., C. M. Myer, 3rd, et al. (1990), Ann Otol Rhinol Laryngol 99(8): 672-3. |