Osteoplastic flap approach versus orbitotomy in case of orbitofrontal cholesterol granuloma

A 44-year-old man developed a slow-growing painless left superolateral orbital mass that extended into the frontal sinus with a complaint of ptosis. Magnetic resonance imaging revealed a heterogenous hyperintense lesion confined to the left frontal bone and superior orbit. The osteoplastic frontal sinus approach was performed to drain supraorbital cholesterol granuloma cyst and for curetting the capsule. Orbitofrontal cholesterol granuloma characteristically arises in the diploe of the superolateral frontal bone. The traditional approach for a primarily orbitofrontal cholesterol granuloma is the transorbital approach including anterior orbitotomy or lateral orbitotomy. However, the osteoplastic approach should be kept in mind as an alternative aprroach for the management of supraorbital lesions in patients with well-pneumatized frontal sinus.