PARAFFIN INDUCED SCLEROSING LIPOGRANULOMA OF EYELIDS AND ANTERIOR ORBIT FOLLOWING ENDONASAL SINUS SURGERY

During the past 5 years we have seen 10 patients who had developed scl erosing lipogranuloma of the lid and orbit after endonasal sinus surge ry with subsequent ipsilateral monocular haematoma. The histopathologi cal examination of all and the additional nuclear magnetic resonance s pectroscopic examination of four surgical specimens in combination wit h the typical clinical course led to the conclusion that the granuloma s were caused by small paraffin droplets. These in turn stemmed from t he ointment plugs applied to the sinuses at the end of the operation, and were washed out into the surrounding tissues by the postoperative haemorrhage. As the chronic and recurring granulomas can lead to consi derable cosmetic and functional impairment, the application of ointmen t plugs at the end of sinus surgery should be abandoned, especially wh en peri- or postoperative bleeding occurs.