Nager G T, Vanderveen T S
Ann Otol Rhinol Laryngol. 1976 Mar-Apr;85(2 pt.1):204-9. doi: 10.1177/000348947608500204.
The cholesterol granuloma does not represent an independent clinical or pathological entity, rather it is a term used for the description of a tissue response of the temporal bone, to the presence of a particular foreign body, i.e., cholesterol crystals. Three factors are considered to play an important role in its development: 1) interference with drainage, 2) hemorrhage, and 3) obstruction of ventilation. The cause of the initial hemorrhage may be a hemorrhagic inflammation or diathesis, a trauma or some other form of vascular disorder. Interference with air exchange and clearance can be caused by: tubal blockage, persistent mesenchyme, polypoid changes, scar formations, tympanosclerosis, cholesteatoma, etc. The cholesterol granuloma may develop in any portion of the pneumatic system of the temporal bone and it can be associated with a variety of middle ear disorders. Its principal precursor is the chronic middle ear effusion or serous otitis media. Its clinical expression and hallmark is the "idiopathic hemototympanum," the dark bluish discoloration of the tympanic membrane. Osteitis and bone erosion are manifestations of an unusual, more advanced stage. Resorption of bone, in a rare instance, may lead to extensive destruction of the temporal bone.
胆固醇肉芽肿并非一个独立的临床或病理实体，而是用于描述颞骨对特定异物（即胆固醇结晶）存在的一种组织反应的术语。三个因素被认为在其形成过程中起重要作用：1）引流受阻，2）出血，3）通气障碍。初始出血的原因可能是出血性炎症或素质、外伤或其他某种形式的血管疾病。空气交换和清除受阻可由以下原因引起：咽鼓管阻塞、持续存在的间充质、息肉样改变、瘢痕形成、鼓室硬化、胆脂瘤等。胆固醇肉芽肿可发生于颞骨气房系统的任何部位，且可与多种中耳疾病相关。其主要前驱病变是慢性中耳积液或浆液性中耳炎。其临床表型和标志是“特发性血鼓室”，即鼓膜呈暗蓝色变色。骨炎和骨质侵蚀是不常见的、更晚期的表现。在罕见情况下，骨质吸收可导致颞骨的广泛破坏。
