Transnasal Endoscopic Treatment of Cholesterol Granuloma of Bilateral Maxillary Sinuses after Facial Trauma:A Case Report

Cholesterol granuloma is formed by granulation reaction against cholesterol crystals that have been precipitated in the tissue. Cholesterol granuloma of the paranasal sinus is rare, but the closed cavities of paranasal sinuses provide favorable conditions for its development. The proposed pathogenesis of cholesterol granuloma seems to be borne by hemorrhages into the sinuses, liberation from degenerating tissue, or transudate. The paranasal sinuses provide closed cavities with a long lymphatic drainage pathway and consequently slow drainage. Since cholesterol granuloma of paranasal sinus have been reported first in 1978, there have been a few reports in this site. Traditional treatment of cholesterol granuloma of maxillary sinus has required complete excision by external approach such as a Caldwell-Luc operation. Recently, authors have experienced a case of cholesterol granuloma developed from the bilateral maxillary sinuses after facial trauma in 42 year-old male patient. We managed this case by transnasal endoscopic sinus surgery successfully. We report this case with literatures review. (Korean J Otolaryngol 2002;45:408-11