Title:
Myospherulosis as a complication of functional endoscopic sinus surgery: a double case report
Authors:
J. Govaerts ,J.-P.Vercruysse , K. Samoy , V. De Groot , M. Jorissen and J. Claes 1
Institutions:
1Department of Otolaryngology and Head Neck Surgery, 3Department of Ophthalmology, University Hospital of Antwerp; Department of Otolaryngology and Head Neck Surgery, University Hospital of Leuven
Keywords:
Paraffinoma; myospherulosis; sclerosing granuloma; paraffin ointment; functional endoscopic sinus surgery; FESS
Pages:
339 - 342
Abstract:
Myospherulosis as a complication of functional endoscopic sinus surgery: a double case report. Introduction: Paraffinomas (also known as sclerosing lipogranulomas or myospherulosis) are a widely acknowledged complication of cosmetic paraffin injections but they are rare following functional endoscopic sinus surgery. Case presentations: Our first case features a 45-year-old woman presenting with a peri-ocular swelling two weeks after functional endoscopic sinus surgery. The procedure was complicated by a fractured lamina papyracea. A nasal packing with antibiotic ointment was left in situ. Initially, the inflammation was controlled successfully with corticosteroids but the swelling persists to this day. Our second case is a 45-year-old man who suffered from a recurrent swelling of the right eyelid after endoscopic sinus surgery. Multiple treatments with oral antibiotics and corticosteroids brought about no improvement. Debulking surgery was performed and a PDS film was placed between the peri-orbita and the bony orbital floor but the swelling recurred. The patient finally consulted a plastic surgeon as a last resort, but the reconstructive procedure only exacerbated the clinical picture. In both cases a biopsy was performed which established the foreign body reaction typical of a paraffinoma. At present, both patients still suffer from this condition. Conclusion: The complete resection of a paraffinoma is seldom possible because of diffuse infiltration and recurrence is very likely. We therefore conclude that paraffin-based ointments should not be used with nasal packing after sinus surgery, especially when there has been a lesion involving the orbital wall.
Issue:
Vol. 9, 2013, 4th trimester


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Myospherulosis as a complication of functional endoscopic sinus surgery: a double case report