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Cholesterol granuloma is a histopathologic term used to describe the giant cell reaction to cho-lesterol deposits that occurs in sequestered, fluid-filled air cells that are normally pneumatized compartments of the temporal bone. It is a benign lesion which is known to be found in the middle ear cavity, mastoid air cells and petrous apex. Although cholesterol granuloma is a patho-logic term describing a tissue response to cholesterol crystals, it is now recognized as a clinical disease entity especially in cases of unilateral blue eardrum without tympanic membrane per-foration. Three factors are considered to play an important role in the development of cholesterol granulomas: obstruction of ventilation, microhemorrhage, and impaired drainage. Cholesterol granulomas are often found as pathologic lesions like granulation tissue in the middle ear an