[Long-term results after therapy of paraffin induced sclerosing lipogranuloma of the eyelids and the anterior orbit in three patients].

Background: Chronic lipogranuloma of anterior orbit and the eyelids is a rare inflammatory pseudotumor with a high tendency of recurrence. It is most commonly related to prior endonasal sinus surgery.

History And Signs: We report on three patients with chronic lipogranulomata who were treated at the university eye-hospital of Düsseldorf during the last 8 years. These cases are discussed individually and longterm results are presented.

Therapy And Outcome: Three patients underwent endonasal surgery with postsurgical use of paraffin nasal packing prior to the occurrence of chronic lipogranulomata. Histologic findings uniformly revealed granulomatous processes but in none was there any sign of a systemic granulomatous disorder (such as Boeck's disease). Additionally, one of these three patients suffered from neuroophthalmologic impairment due to infiltration of oculomotore structures. Early surgical treatment if only for extended biopsy did result in immediate severe recurrence of the disease. No recurrence of the disease has been observed, however, if surgery was duely postponed.

Conclusions: Lipogranulomata seem to be caused by postsurgical paraffin nasal packing. Early treatment seems to be unfavourable because of the high tendency of recurrence. Surgical removal of any tumor masses should be delayed therefore till granuloma formation has presumably come to an end. Any early surgery should be limited to a diagnostic biopsy if judged necessary.