To the Editor.—I would like to comment on the case report entitled "Giant Cholesterol Cyst of the Petrous Apex", by Sataloff et al that appeared in the April 1988 issue of the Archives.1
The authors are describing what most otologists refer to as cholesterol granulomas of the petrous apex. They contend that there is a difference between a cholesterol cyst and a cholesterol granuloma, but fail to prove such a distinction in their article. They are incorrect in stating that cholesterol granulomas (of the petrous apex) most commonly develop after infection or surgery. The distinction that they are trying to make between these two entities is clearly artificial.
Cholesterol granulomas of the petrous apex often present with cranial nerve findings. In their references, the authors fail to cite one of the most complete articles written on cholesterol granuloma of the petrous apex, and probably the largest series ever
BENECKE JE. Cholesterol Granulomas of Petrous Apex. Arch Otolaryngol Head Neck Surg. 1988;114(11):1334. doi:10.1001/archotol.1988.01860230128043
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