SCLEROSING LIPOGRANULOMA (PARAFFINOMA) OF THE EYELIDS AND THE ORBIT AFTER ENDONASAL SINUS SURGERY

During the last five years 10 patients received surgical treatment in our eye clinic for tumours of the eyelids and the orbit that had devel oped after endonasal sinus surgery. In most patients the first signs o f lid or orbital involvement had occurred 4 weeks after ENT surgery an d after a unilateral or bilateral postoperative haematoma had subsided . The histological examination of the surgical specimens showed chroni c sclerosing lipogranuloma containing large vacuoles surrounded by epi theloid and giant cells, typical of a so-called paraffin granuloma. MR -spectroscopy detected high concentrations of paraffin in the specimen s of 3 patients. Since paraffin is a constituent of many ointments, we assume that the granulomatous reaction was elicited by the ointment t ampons routinely applied to the wound area following sinus surgery. Th e bleeding acted as a vehicle to distribute the paraffin into the surr ounding tissues.