Cholesterol granuloma of the maxillary antrum

A case of cholesterol granuloma of the maxillary antrum is presented, the eighth reported case in the ENT literature. It is postulated that a maxillary antral cholesterol granuloma could be associated with obstruction of the antral ostia, hemorrhage into polypoidal mucosal disease or that an antral cyst may have developed a cholesterol granuloma in its walls as a result of cholesterol precipitation. A review of the literature on cholesterol granuloma suggests that it is a condition which arises in a closed space with poor ventilation or drainage, with long-standing inflammation with effusion or hemorrhage contributing to the formation of free cholesterol crystals derived from tissue or blood breakdown products. The foreign body granuloma produced in this way is then self-perpetuating and requires complete removal for cure rather than a simple drainage procedure.