[Twenty four cases of cholesterol granuloma of the paranasal sinuses]

To investigate the etiology and pathogenesis of cholesterol granuloma of the paranasal sinuses and the treatment for the disease.

Twenty four cases of cholesterol granuloma of the paranasal sinuses treated in our hospital during the period from March 1996 to March 2003 were retrospectively analysed. All cases were verified by surgery and pathology.

Of all cases, 10 cases were diagnosed as chronic sinusitis, 8 cases as nasal sinus cyst, and 5 cases as nasal polyp before operation, only 1 case was considered as cholesterol granuloma. The main symptoms were nasal obstruction (20/24), rhinorrhea (18/24), dysosmia (10/24), headache (7/24), pain around the eye (5/24), double vision (2/24), et al. Different surgical approaches were selected depending upon different pathological changes. Good results were obtained in 23 cases and postoperative follow-up for at least one year showed no recurrence. Only one case received revision nasal endoscopic surgery two years after Caldwell-Luc operation because of recurrence, and remained symptom-free for three years.

The pathogenesis of cholesterol granuloma includes obstruction of ventilation and drainage and brooding in sinuses. Cholesterol granuloma of the paranasal sinuses seems to have a close relation with chronic sinusitis, especially sinus mucocele. The surgical approach depends upon the location, extension, and severity of the lesion. The principle of surgery is to eliminate the pathological focus and create an adequate drainage.