[Petrous apex cholesterol granulomas]

Cholesterol granulomas are characterized by an inflammatory reaction with giant cells in response to products of hemoglobin degradation. It can develop in different tissues throughout the body, but as a lesion of the petrous apex it is an own entity. Clinical symptoms may be hearing loss, vertigo, and headache as well as affections of the V-VIII (th) cranial nerves or seizure. Cholesterol granulomas can be identified by typical radiological findings in CT and MRI. Although an unusual entity, cholesterol granulomas are high on the differential of petrous apex lesions and need to be resected via an infralabyrinthine, translabyrinthine or transsphenoidal approach with an establishment of a permanent drainage route in cases of symptomatic clinical presentations.