Cholesterol granuloma of the sphenoid sinus

Objectives: Cholesterol granuloma of the sphenoid sinus has rarely been reported. Methods: A 50-year-old man visited our hospital presenting with a 2-year history of intermittent right-sided headache, 1-month history of right-sided tinnitus, and 5-year history of nasal obstruction and purulent nasal discharge. Computed tomography revealed a well-demarcated expansile mass in the right sphenoid sinus with perifocal bony erosion and almost complete dehiscence of the lateral wall of the right sphenoid sinus. The patient subsequently underwent endoscopic sphenoid sinusotomy guided by a navigation system. Results: After surgery, the patient was diagnosed with cholesterol granuloma of the sphenoid sinus. The patient's symptoms improved, and no complications were reported. Conclusions: Cholesterol granuloma is extremely rare and should be considered in the differential diagnosis of an expansile mass in the sphenoid sinus. Endoscopic sphenoid sinusotomy guided by a navigation system is a safe and effective treatment for cholesterol granuloma of the sphenoid sinus.