Cholesterol Granuloma of the Maxillary Sinus Misdiagnosed as Nasal Polyp or Mucocele: Four Cases

Abstract

Cholesterol granuloma is commonly found in the mastoid air cells but is rare in the paranasal sinuses. The most commonly affected sinuses are the frontal sinus, followed by the maxillary sinus. Cholesterol granuloma can be difficult to diagnose because clinical manifestations and radiologic findings are similar to those of other sinonasal disorders. The authors observed 4 cases of cholesterol granuloma that were preoperatively suspected to be nasal polyps or mucoceles. Here, the authors report on their clinical presentation and their successful treatment using the endoscopic sinus approach. These cases expand the current literature on cholesterol granuloma in the paranasal sinuses.

Systematic identification and characterization of clinical and socio-economical correlates of granulomatous nasal and para-nasal sinuses: A large-scale study among patients of Odisha, India

“…The occurrence of TB and LEP granulomatous nasal disorders was the least among patients in this study with incidence rate between ∼1-2% only ( Table 1 , Figure 1 A), mostly reported in females of low-socioeconomic background, similar to that of RSC cases. Such a low prevalence of TB and LEP granulomatous nasal disorder have been reported previously in different Asian and Caucasian populations and therefore we have not subsequently focussed on these forms of granulomas ( Foxen, 1979 ; Hassan and Goh, 2012 ; Kim et al., 2021 ; Kulkarni, 2011 ). Lastly, frequent occurrence of RSC, TB and LEP cases in middle-aged females (in comparison with age-matched males) suggest that the responsible pathogen for these cases is likely to be widely present in home or local community spaces in rural areas and lack of social and female hygiene could also play an important role ( Cabral et al., 2022 ; Guarner, 2012 ; Pagan and Ramakrishnan, 2014 ; Ploemacher et al., 2020 ).…”

Cholesterol Granuloma of the Maxillary Sinus in the Patient Operated With Prediagnosis of Sinonasal Polyp: A Case Report

“…[3] It is discovered in a wide age range (22-85 years) and most often found in middle-aged males. [3,5,7] Male/female ratio is 3/1. [8] Although, it has no characteristic clinical and radiological symptom, the most frequent hospital admission causes of the patients are single-sided nasal obstruction, nasal discharge and pain.…”

“…[8] Although, it has no characteristic clinical and radiological symptom, the most frequent hospital admission causes of the patients are single-sided nasal obstruction, nasal discharge and pain. [3,5,7] However, its most specific symptom is clear golden-yellow nasal discharge. [7] It has been reported to be most commonly seen in frontal sinuses and followed by maxillary sinuses.…”

“…[3,5,7] However, its most specific symptom is clear golden-yellow nasal discharge. [7] It has been reported to be most commonly seen in frontal sinuses and followed by maxillary sinuses. [7,9] It is encountered in the right and left maxillary sinuses with similar rates.…”

“…[7] It has been reported to be most commonly seen in frontal sinuses and followed by maxillary sinuses. [7,9] It is encountered in the right and left maxillary sinuses with similar rates. [5] Bilateral cases also have been reported in the literature.…”