Cholesterol Granuloma Development following Temporal Bone Surgery. (June 2016)

• Record Type: Journal Article
• Authors: Sweeney, Alex D.; Osetinsky, L. Mariel; Hunter, Jacob B.; Haynes, David S.; Carlson, Matthew L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 154:Number 6(2016:Jun.)
• Page Start: 1115
• Page End: 1120
• Publication Date: 2016-06
• Subjects: cholesterol granuloma -- skull base -- tympanomastoidectomy -- temporal bone; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599816630954
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To describe the clinical presentation and management of patients with cholesterol granulomas (CGs) that develop following temporal bone surgery. Study Design: Case series with chart review. Setting: Two independent tertiary academic referral centers. Subjects and Methods: 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. Results: 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. Conclusion: 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.