Yokoi Hidenori, Yamanaka Hidetaka, Matsumoto Yuma, Kawada Michitsugu, Fujiwara Masachika, Ohara Arisa, Saito Koichiro
Department of Otolaryngology, Head and Neck Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan.
SAGE Open Med Case Rep. 2020 Feb 16;8:2050313X20907809. doi: 10.1177/2050313X20907809. eCollection 2020.
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.
眶额部胆固醇肉芽肿较为罕见。在此，我们报告一例64岁男性复发性眶额部胆固醇肉芽肿患者，采用改良Lothrop（Draf III）手术进行治疗。该患者有外伤史及既往鼻窦手术史，主要症状为鼻塞、嗅觉减退和复视。我们怀疑为慢性鼻窦炎；计算机断层扫描显示软组织阴影从双侧额窦延伸至筛窦，右侧眶额部区域有一个囊肿。我们进行了内镜手术切除肿物，切除标本的组织病理学分析确诊为胆固醇肉芽肿。病变在2个月后复发，我们采用改良Lothrop或Draf III手术进行了翻修手术。患者在5年随访中未出现复发。这些发现表明，Draf III手术是治疗胆固醇肉芽肿的一种有效手术方法。
