chlortetracycline and Granuloma--Giant-Cell

We report on an instructive case of an infrequent but severe complication after paranasal sinus surgery. The use of ointment-covered nasal packing for haemostasis can cause inoculation of ointment into the orbita, if the medical orbital wall has been injured intraoperatively. A postoperative intraorbital haematoma may spread ointment droplets into subcutaneous tissues of the eyelid and cause local sclerosing lipogranulomatosis. The case reported here underlines the resulting therapeutical problems as have been mentioned in the literature. Only complete excision of the lipogranuloma can prevent recurrences. We conclude that ointment should not be used with nasal packings after paranasal sinus surgery if an intraoperative lesion of the orbital wall is likely to occur.

Topics: Administration, Intranasal; Chlortetracycline; Ethmoid Sinus; Eyelid Diseases; Eyelids; Female; Granuloma, Giant Cell; Hemostasis, Surgical; Humans; Middle Aged; Nasal Polyps; Ointments; Paranasal Sinus Neoplasms; Postoperative Complications; Reoperation