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the paranasal sinuses and orbit. It is currently thought that impaired drainage, hemorrhage and inadequate ventilation play significant roles in its pathogenesis. Histopathologic examination of cholesterol granuloma shows abundant foreign body giant cells, cholesterol crystal clefts, histiocytes surrounded by a dense fibrous capsule. We report our endoscopic surgical experience in one female patient with a large cholesterol granuloma of the sphenoid sinus presenting bilateral visual invol-vement and brain invasion. (Korean J Otolaryngol 2002;45:293-5)