Cholesterol granuloma of the maxillary sinus in a young patient with associated neurosurgical pathology

Summary 

The cholesterol granuloma is a frequent exhibit in otomastoid inflammatory pathology. The evidence of such in the nasal-sinus region is rarely described in the literature. The diagnosis is usually difficult because the clinical, endoscopic and radiological findings are non-specific. In our study we are describing a case of cholesterol granuloma of the maxillary sinus found in a 16-year-old who presented an endoscopic exhibit suggesting antrochoanal polyp. The CT scan also showed an arachnoid cyst that caused frequent epileptic episodes in the patient. The neoformation was therefore extracted via endonasal endoscopy including the base of implantation. A few days after the boy was discharged he was hospitalized again because of the appearance of a chronic subdural hematoma and was treated by neurosurgical drainage.

The clinical, radiological and histopathological characteristics of the cholesterol granuloma of the maxillary sinus are largely discussed researching the possible correlations with the associated neurosurgical pathology.

Keywords: Cholesterol granuloma, Arachnoid cyst, Subdural hematoma, Endoscopic sinus surgery, Antrochoanal polyp