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In this case, cholesterol granuloma was limited to the epitympanic and mesotympanic regions. For small cholesterol granulomas confined to the middle ear, a canal wall-up or wall-down tympanoplasty plus ventilation tube insertion are usually performed. In this case, primary endoscopic surgery was performed under general anaesthesia to remove the presumed cholesterol granuloma. It was completely removed by this approach, without facial nerve injuries or postoperative complications. The patient had no disease recurrence at clinical and radi
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