Description

Objective: We present the unique case of well defined,
thick walled cholesterol granuloma of the mastoid tip
associated with bone destruction in the presence of an aberrant
sigmoid sinus. We also review the world literature concerning
the rare phenomenon of aggressive cholesterol granulomas and
even rarer aberrant sigmoid sinus.

Method: Case reports and a review of the world
literature concerning cholesterol granulomas and sigmoid
sinus anatomy are presented.

Results: The patient presented is a 32 year old male
Caucasian who presented to our services complaining of
otalgia. An MRI scan was performed and the patient
underwent mastoidectomy.

Conclusion: Cholesterol granulomas are a
particular form of granulation tissue. Otologists usually
encounter the benign variant during cholesteatoma or
chronic otitis media surgery. Well organized thick walled
cholesterol granulomas associated with bony destruction are
rare. Very little literature exists concerning anatomical
variations of the sigmoid sinus.