Ear exam

Cholesterol Granuloma

Cholesterol granulomas are rare, benign tumors or cysts that develop at the tip of the petrous apex, a part of the skull next to the middle ear.

While benign, cholesterol granulomas are still dangerous as they can grow and push up against the ear and important facial nerves.


Symptoms may include:

  • Hearing loss in one ear
  • Ringing in the ears (tinnitus)
  • Facial twitching
  • Vertigo
  • Facial numbness


Examination of the ear with an otoscope may reveal the eardrum to appear blue in color, or a brownish protrusion may be present behind it. Imaging tests such as MRI and CT scans can detect cholesterol granuloma.

An audiogram may be performed to assess any hearing loss.


Moderately sized lesions require drainage and ventilation of the cholesterol granuloma.

In more severe cases where the granuloma is large and destructive, surgical removal may be indicated. The surgical approach depends on the exact location of the tumor and the status of the patient’s hearing. In most cases, our highly specialized surgeons use minimally invasive endoscopic endonasal surgery to reach the petrous apex and remove the cholesterol granuloma through the nose.

Written and reviewed by:
We are a highly specialized team of medical professionals with extensive neurological and cranial disorder knowledge, expertise and writing experience.
Last updated: June 7, 2022