Endoscopic approach to orbitofrontal cholesterol granuloma.

A 54-year-old man presented with an orbitofrontal cholesterol granuloma arising in the left frontal bone and abutting the dura. The lesion was successfully removed with an anterior orbitotomy via a superior lid crease incision. A 70-degree rigid endoscope was used to visualize removal of the granuloma from the inner surface of frontal bone and the dura. The patient made an uncomplicated recovery and there was no recurrence at two years follow-up. A combined anterior orbital and endoscopic approach may be an alternative to either frontal craniotomy or lateral orbitotomy in selected cases of orbitofrontal cholesterol granuloma.