title: Myospherulosis as a complication of functional endoscopic sinus surgery: a double case report.
abstract: BACKGROUND
  Paraffinomas (also known as 'sclerosing lipogranulomas' or 'myospherulosis') are a widely acknowledged complication of cosmetic paraffin injections but they are rare following functional endoscopic sinus surgery.
  
  
  METHODS
  Our first case features a 45-year-old woman presenting with a peri-ocular swelling two weeks after functional endoscopic sinus surgery. The procedure was complicated by a fractured lamina papyracea. A nasal packing with antibiotic ointment was left in situ. Initially, the inflammation was controlled successfully with corticosteroids but the swelling persists to this day. Our second case is a 45-year-old man who suffered from a recurrent swelling of the right eyelid after endoscopic sinus surgery. Multiple treatments with oral antibiotics and corticosteroids brought about no improvement. Debulking surgery was performed and a PDS film was placed between the peri-orbita and the bony orbital floor but the swelling recurred. The patient finally consulted a plastic surgeon as a last resort, but the reconstructive procedure only exacerbated the clinical picture. In both cases a biopsy was performed which established the foreign body reaction typical of a paraffinoma. At present, both patients still suffer from this condition.
  
  
  CONCLUSIONS
  The complete resection of a paraffinoma is seldom possible because of diffuse infiltration and recurrence is very likely. We therefore conclude that paraffin-based ointments should not be used with nasal packing after sinus surgery, especially when there has been a lesion involving the orbital wall.
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, University Hospital of Antwerp.
authors.forename: J
authors.initials: J
authors.lastname: Govaerts
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, University Hospital of Antwerp.
authors.forename: J P
authors.initials: JP
authors.lastname: Vercruysse
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, University Hospital of Leuven.
authors.forename: K
authors.initials: K
authors.lastname: Samoy
authors.affiliation: Department of Ophthalmology, University Hospital of Antwerp.
authors.forename: V
authors.initials: V
authors.lastname: De Groot
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, University Hospital of Leuven.
authors.forename: M
authors.initials: M
authors.lastname: Jorissen
authors.affiliation: Department of Otolaryngology and Head Neck Surgery, University Hospital of Antwerp.
authors.forename: J
authors.initials: J
authors.lastname: Claes
mesh_terms: D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods*; D005260:Female; D015745:Granuloma, Foreign-Body / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009824:Ointments / Q000009:adverse effects; D010256:Paranasal Sinuses / Q000601:surgery*
chemical_list: D009824:Ointments