Cholesterol granuloma of the maxillary sinus encountered during floor augmentation procedure: A case report

Modified Lothrop (Draf III) procedure for the treatment of a recurrent orbitofrontal cholesterol granuloma: A case report

Orbitofrontal cholesterol granuloma is a rare occurrence. Here, we present a case involving a 64-year-old man with a recurrent orbitofrontal cholesterol granuloma treated by the Modified Lothrop (Draf III) procedure. The patient, who had a history of trauma and previous sinus surgery, presented with chief complaints of nasal congestion, olfactory impairment, and diplopia. We suspected chronic sinusitis; computed tomography showed a soft-tissue shadow extending from the bilateral frontal sinuses to the ethmoid sinuses, with a cyst in the right orbitofrontal region. We performed endoscopic surgery for removal of the mass, and histopathological analysis of the resected specimen confirmed a diagnosis of cholesterol granuloma. The lesion recurred 2 months later, and we performed revision surgery using the Modified Lothrop or Draf III procedure. The patient showed no relapse at the 5-year follow-up. These findings suggest that the Draf III procedure is an effective surgical treatment for cholesterol granulomas.

Cholesterol Granuloma in the Maxillary Sinus: Are Endodontically Treated Teeth Involved in Its Etiopathogenesis?

Cholesterol granuloma (CG) is a tissue reaction in response to the accumulation of cholesterol crystals rarely found in the maxillary sinus. The etiopathogenesis of maxillary sinus CG remains unclear. We reviewed the literature and added two new reports of cholesterol granuloma in maxillary sinus related to endodontically treated maxillary posterior teeth. The first report refers to a 45-year-old woman diagnosed with rhinitis, who was submitted to endodontic retreatment of maxillary molar, and subsequently showed maxillary sinus opacity with cystic appearance. The second case describes a young adult woman, who presented a cystic mass in maxillary sinus after endodontic treatment, in close association with the apex of the maxillary right second premolar. Both patients were treated by a classic Caldwell-Luc surgery and the microscopic analyses revealed maxillary sinus CG. In the following, the authors discuss the probable involvement of endodontically treated maxillary posterior teeth in the etiopathogenesis of maxillary sinus CG.