[Chronic lipogranuloma of the eyelids after paranasal sinus operations]

Over a period of about 1 year we observed five patients who developed tumors of their eyelids a few days to 3 weeks after surgery on the paranasal sinuses through the nasal passage. One patient noticed a swelling of his ipsilateral eyelid during an irrigation procedure for the maxillary sinus, which was also followed by endonasal surgery. After surgery each patient developed an ipsilateral periorbital hematoma and subsequently solid indolent tumors of the eyelid without a tendency to regress over a period of 3 to 14 months. Therefore, surgical treatment was necessary. The histological examination showed lipogranulomas with giant cells and many lipid vacuoles of different size. Exploring the origin of these lipids, we performed a magnetic-resonance-spectrum analysis of one tumor sample. We predominantly found signals for linear hydrocarbons, which are the main components in paraffin-liquids. We presume that our patients developed lipogranulomas of their eyelids due to the paraffin introduced into the tissue by the ointment used to tampon the paranasal sinus after endonasal surgery.