What Cholesterol Granuloma Really Does To Your Ears

When you hear about cholesterol, it often refers to the waxy stuff circulating through your bloodstream. However, cholesterol granulomas are something entirely different. These are small cyst-like growths that can form on the bone next to your middle ear (called the petrous apex) due to inflammation. Inside these granulomas are cholesterol crystals and other fluids.

Although a small cholesterol granuloma might not cause any symptoms, one of the most common symptoms is hearing loss in the affected ear. These lesions could also cause ringing in the ears (tinnitus) or vertigo. You might also experience facial twitching or numbness because many nerves surround the petrous apex bone. Larger cholesterol granulomas that are left untreated could cause bone loss, nerve damage, or permanent loss of hearing.

(Read what might happen if hearing loss goes untreated.)

Cholesterol granulomas don't develop if you have high cholesterol, nor does high cholesterol put you at risk. Instead, they are likely to form due to chronic middle ear infections or some trauma to that part of your head. Blocked airflow can cause pressure to build up in this area, causing minor bleeding and inflammation that forms into a cyst.

One thing to note is that cholesterol granulomas don't appear on or underneath your skin like a wart or a blister. If you have symptoms such as dizziness, facial numbness, or hearing loss, your doctor might take a look inside your eardrum and then order imaging such as an MRI or CT scan to get an accurate diagnosis.

If your cyst is small or you don't have severe symptoms, your doctor might recommend just monitoring that area to see how quickly it grows. Sometimes a cholesterol granuloma can be drained through the nose or ear using an endoscope. This is a procedure that doesn't require an incision. In some instances where the lesion is large or hasn't drained properly, surgery might be required.

Cholesterol granulomas are very rare, but they are one of the more common types of cysts found on the petrous apex. A 2022 article in Radiology Case Reports highlighted a man who came to a neurology clinic complaining about seizures, headaches, ringing in the ear, fainting, and pain on one side of his face. His medical background was relatively healthy aside from chronic ear infections. An MRI showed a cholesterol granuloma on the petrous apex, but it had grown so large that it put pressure on his brainstem and cerebellum.

Cholesterol granulomas aren't caused by your cholesterol levels, diet, or exercise habits, so managing these factors won't help prevent them. However, you can potentially lower your risk by addressing middle ear infections, which are often associated with cholesterol granulomas. Middle ear infections can result from bacteria like Streptococcus or develop during a cold, especially when the tube connecting your nose and middle ear (the Eustachian tube) becomes swollen from allergies or congestion. This swelling can trap fluid, creating an environment for infection.

To reduce the chances of ear infections, focus on preventing colds by washing your hands frequently and keeping commonly touched surfaces clean. Clearing out your nasal passages with a saline solution or neti pot can also help flush out allergens and mucus that might lead to congestion. For ear hygiene, avoid using cotton swabs, as they can push wax deeper into your ear canal. Instead, let earwax naturally wash out during a shower and gently blot your ears with a tissue afterward. By taking these steps, you can help minimize the risk of ear infections that may contribute to cholesterol granulomas.