Cholesterol granuloma of the cerebellopontine angle

Two unusual cases of cholesterol granuloma of the temporal bone manifested as cerebellopontine angle tumors. To our knowledge, cerebellopontine angle extension of this lesion has not previously been reported. Obstruction of ventilation and drainage of any air complex in the temporal bone may produce cholesterol granuloma. Asymptomatic involvement of the mastoid air cell system is common in chronic otitis media. Surgical management of cholesterol granuloma with cerebellopontine angle extension is recommended. Total excision of the lesion is preferred; marsupialization into the mastoid air cell system is an alternative if excision would produce a major neurologic deficit.