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Orbital and palpebral paraffinoma
R Feldmann1, M Harms, P Chavaz
1Hôpital Cantonal Universitaire, Genève, Switzerland.
Abstract:
Paraffinoma is a well-recognized complication of paraffin injection. We describe a 44-year-old man who had an ethmoidectomy for chronic sinusitis. A communicating fracture of the ethmoid bone into the orbit occurred intraoperatively. The nasal cavity was subsequently packed with gauze containing a petrolatum-based antibiotic ointment. Bilateral, periocular swelling developed 1 week later. Optical and electron microscopic studies revealed a paraffinoma.
Insights
Paraffinoma, a complication of paraffin injection, can occur after ethmoidectomy. This case highlights petrolatum-based ointment packing leading to periocular swelling and confirmed paraffinoma.
Area of Science:
- Ophthalmology
- Otolaryngology
- Pathology
Background:
- Paraffinoma is a known complication associated with the injection of paraffin. Chronic sinusitis necessitates surgical intervention, such as ethmoidectomy.
- Intraoperative complications, including orbital fractures during ethmoidectomy, can occur, necessitating specific post-operative management strategies.
Observation:
- A 44-year-old man developed bilateral periocular swelling one week after an ethmoidectomy for chronic sinusitis.
- The complication arose after the nasal cavity was packed with gauze containing a petrolatum-based antibiotic ointment following an intraoperative ethmoid bone fracture into the orbit.
Findings:
- Optical and electron microscopy confirmed the presence of paraffinoma.
- The findings indicate that petrolatum-based materials, when used for nasal packing, can lead to paraffinoma formation.
Implications:
- This case underscores the importance of considering alternative packing materials or techniques to prevent paraffinoma in post-ethmoidectomy patients.
- Awareness of this complication is crucial for surgeons performing ethmoidectomies, especially when orbital involvement or specific packing materials are present.
- Further research into the long-term effects and optimal management of iatrogenic paraffinoma is warranted.