title: [Diagnosis and management of lipogranuloma of the eyelids from nasal endoscopic surgery].
abstract: OBJECTIVE
  To enhance the safety of nasal endoscopic surgery and decrease its complications of eyes.
  
  
  METHODS
  Three patients of chronic rhinosinusitis and nasal polyposis with lipogranulomas of the eyelids after nasal endoscopic surgery and nasal packing of petrolatum gauze were reported and analyzed, and their treatment results were presented during the last 2 years.
  
  
  RESULTS
  The medial orbital wall injury occurred in all three patients during endoscopic sinus surgery. The patients developed an ipsilateral periocular swelling, eyelid hematoma and palpebral conjunctival edema during 2 to 3 hours after surgery. Nasal packs petrolatum gauze were removed 10-24 hours after surgery. The patients were discharged from hospital when periorbital swelling and eyelid ecchymoma disappeared, and nasal cavity obstruction was improved 6 to 8 days after surgery. The swelling and nodular mass of ipsilateral eyelids (one in left upper eyelid and two in right lower eyelid) were found 12-15 days after surgery, and their eye movement and eyesight were normal. Antibiotic and corticosteroid were administered for 3 4 weeks with only improvement in eyelid swelling. These masses of eyelids were completely excised through palpebral margin 1-6 months after surgery. The histopathological examination of the surgical specimens showed lipogranuloma. No recurrence and symptom of the eyes had been observed during 4-18 months follow up.
  
  
  CONCLUSIONS
  The lipogranuloma of the eyelid is a rare and late complication after nasal endoscopic surgery and nasal packing with vaspetrolatum gauze. The medial orbital wall injury and bleeding during surgery, and vaseline of nasal packing permeated into the eyelid are the direct causes of this complication. The application of petrolatum gauze should be avoided when the medial orbital wall trauma is identified. The complete excision of granulomas is a best effective therapy.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha, 410011, China. y88k2000@yahoo.com.cn
authors.forename: Yunkai
authors.initials: Y
authors.lastname: Guo
authors.forename: Anquan
authors.initials: A
authors.lastname: Peng
authors.forename: Dan
authors.initials: D
authors.lastname: Xie
authors.forename: Youzhong
authors.initials: Y
authors.lastname: Li
authors.forename: Jihao
authors.initials: J
authors.lastname: Ren
authors.forename: Manyi
authors.initials: M
authors.lastname: Xiao
authors.forename: Songqing
authors.initials: S
authors.lastname: Fan
authors.forename: Xinming
authors.initials: X
authors.lastname: Yang
authors.forename: Weijing
authors.initials: W
authors.lastname: Wu
authors.forename: Dinghua
authors.initials: D
authors.lastname: Xie
mesh_terms: D000328:Adult; D004724:Endoscopy / Q000009:adverse effects; D005141:Eyelid Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy