The cholesterol granuloma may develop in any portion of the pneumatic system of the temporal bone and it can be associated with a variety of middle ear disorders. Three factors are considered to play an important role in its development : 1) interference with drainage 2) hemorrhage and 3) obstruction of ventilation. Its principal precursor is chronic middle ear effusion or serous otitis media. The authors have recently experienced a case of stenosis of the external auditory canal due to cholesterol granuloma which was suspected not to be associated with middle ear disorders.