• Journal of Rhinology
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• 제25권2호
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• pp.108-113
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• 2018

Cholesterol granuloma is a disease in which cholesterol crystals act as a foreign substance in the surrounding tissues and cause granulomatous reaction and fibrosis within the chamber. It is found in various locations of the body, but the most common location is the temporal bone associated with middle ear disease. Because the disease is associated with breathing disturbance, it may also occur in the paranasal sinus. However, it has been rarely reported since its first report by Graham and Michaels in 1978. Recently, we experienced a case of cholesterol granuloma of the right maxillary sinus of a 63-year-old female patient without any nasal symptoms. We successfully managed this case with Caldwell-Luc operation. Also, we summarized the cases of cholesterol granuloma of the sinonasal region reported in Korea.

• 대한청각학회지
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• 제24권4호
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• pp.210-213
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• 2020

Fungal balls consist of rounded conglomerates of fungal mycelia, which can form within a preexisting cavity. They are mostly found in the paranasal sinuses in the head and neck regions. Cholesterol granuloma is a fibrotic lesion that develops as a tissue response to a foreign body such as cholesterol crystals or hemosiderin and is often associated with chronic otitis media. We present the unusual case of a 62-year-old male who was treated for chronic otitis media, which was histologically confirmed as a fungal ball and cholesterol granuloma in the middle ear cavity following tympanomastoidectomy. This is the first reported case of synchronous fungal ball and cholesterol granuloma in the middle ear cavity.

• Journal of Audiology & Otology
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• 제24권4호
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• pp.210-213
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• 2020

Fungal balls consist of rounded conglomerates of fungal mycelia, which can form within a preexisting cavity. They are mostly found in the paranasal sinuses in the head and neck regions. Cholesterol granuloma is a fibrotic lesion that develops as a tissue response to a foreign body such as cholesterol crystals or hemosiderin and is often associated with chronic otitis media. We present the unusual case of a 62-year-old male who was treated for chronic otitis media, which was histologically confirmed as a fungal ball and cholesterol granuloma in the middle ear cavity following tympanomastoidectomy. This is the first reported case of synchronous fungal ball and cholesterol granuloma in the middle ear cavity.

• 대한두개안면성형외과학회지
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• 제22권1호
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• pp.26-32
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• 2021

Background: Various substances are currently being used for cosmetic or postsurgical reconstruction reasons. Injecting of various materials into the face may provoke inflammatory or granulomatous reactions, infection and tissue necrosis. Among these reactions are foreign body granulomas. This study aims to describe the clinical characteristics of and therapeutic approaches used in patients with facial foreign body granulomas caused by the injection of various substances. Methods: From 2007 to 2020, a total of 64 patients visited our hospital due to inflammatory signs, palpable masses or surface irregularities. We reviewed patient characteristics, type of injected material, medical history and treatment outcomes. The treatment results were scored with patient satisfaction and statistical analysis of the treatment period was performed. Results: Most patients underwent conservative treatment followed by surgical treatment because of persistent symptoms; one patient did not require surgery. All patients reported good treatment results and satisfaction. The earlier the surgical treatment was performed, the shorter the treatment period and the higher patient satisfaction scoring. Conclusion: Granulomatous changes to the face are an emerging concern in various cosmetic procedures and surgeries, including fillers, silicone implants and autologous fat injections. Our findings strongly suggest that patient symptoms require accurate diagnosis and surgical treatment.

• 대한세포병리학회:학술대회논문집
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• 대한세포병리학회 1991년도 제5차 춘계학술대회 초록집
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• pp.16-16
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• 1991

• Archives of Plastic Surgery
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• 제32권1호
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• pp.131-134
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• 2005

It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

• Archives of Plastic Surgery
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• 제38권4호
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• pp.391-397
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• 2011

Purpose: The injection of various materials, including medical fillers and unregulated products, is widespread, potentially causing the development of foreign body granulomas. Should this occur on the nose, the contour deformity and inflammatory signs that result from these granulomas are aesthetically undesirable to patients. The purpose of our study is to share our experiences using different surgical approaches, depending on the affected portion of the nose, to optimize management of this challenging problem and to evaluate patient's satisfaction using our in-house questionnaire along with degree of improvement by two independent plastic surgeons. Methods: We treated 18 patients who underwent surgical excision of nasal foreign body granulomas via a perilesional approach to the lesion (n=12) or by transcolumellar incision (n=6) at our hospital over a period of seven years from March 2003 to October 2010. Nonparametric statistics were used and are presented as medians (25th-75th). Patient satisfaction was evaluated on a scale of 1 to 5 using an in-house questionnaire. All pre-and post-operative photographs were analyzed by two independent plastic surgeons. Post-operative outcomes were evaluated based on the surgeons' consensus ratings. Results: All patients receiving the transcolumellar approach reported a high level of satisfaction with the results. All but two patients who received the perilesional approach were satisfied with the outcome. No outcomes were rated as no change or worse by the consensus ratings. Conclusion: For the upper two-thirds of the nose, perilesional surgical excision can lead to substantial patient satisfaction with modified contour deformity and infection control. The transcolumellar approach resulted in better outcomes and patient satisfaction for the lower one-third of the nose.

• 대한두개안면성형외과학회지
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• 제17권3호
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• pp.169-172
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• 2016

Dermal fillers are generally accepted as safe and well-tolerable cosmetic tools. However, adverse reactions have been reported in the literature. Here, we present a case of atypical facial filler granuloma and compare its histologic features with those of the classic paraffinoma.

• Imaging Science in Dentistry
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• 제37권4호
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• pp.225-230
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• 2007

Cholesterol granuloma is an unusual clinical entity described as an inflammatory granulation in response to the deposit of cholesterol crystals. It can develop in any portion of air cells within the temporal bone as a result of a lack of aeration and inadequate drainage, especially in the middle ear cavity. Here, we report very unusual three cases of cholesterol granuloma developed in mandible. In the first case a 68-year-old male with a large mass arising from the mandible was observed. Panoramic radiograph and computed tomography scans revealed a huge expanding lesion in the mandible. In the second case a 47-year-old female with a cystic lesion in the mandible was observed. And in the third case a 19-year-old male complaining atypical facial pain had a large lesion in the mandibular ramus. The histopathologic examinations of the cases showed numerous cholesterol crystals surrounded by multinucleated foreign body giant cells.

• Archives of Plastic Surgery
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• 제48권4호
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• pp.366-372
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• 2021

Background The result of illicit polymer injection is chronic inflammation with foreign-body granuloma (FBG) formation. Treatment can be divided into medical and surgical. Some patients develop severe complications with need surgical treatment. This study aims to describe patients who underwent surgical removal of the FBGs and autoimmune/inflammatory syndrome induced by adjuvants (ASIA); additionally, we evaluated the quality of life after surgery. Methods In this retrospective single-center study, the authors examined data of patients who underwent surgical removal of FBG caused by illicit polymer injection for cosmetic purposes and confirmed ASIA from 2015 to 2020 by three different surgical approaches. Descriptive summary statistics were reported on patient demographics, presenting symptoms and clinical examination features, treatment strategies, histopathology reports and quality of life. Results The cohort included 11 female patients with FBGs and ASIA. The most affected anatomical zones were the combination of gluteal region, thighs and legs (40%); and thighs with legs (20%). Main presentation was: skin hyperpigmentation (90.9%), skin induration (63.6%), chronic fatigue (63.6%), and ulcers (36.4%). Surgical modalities consisted of: ultrasonic-assisted liposuction in four patients (36.4%); open en bloc excision and primary closure in four patients (36.4%); and open en bloc excision and microsurgical reconstruction in three patients (27.2%). The postoperative quality of life visual analog scale score was 83.9. Conclusions ASIA treatment represents a challenge for the plastic surgeon. Adequate surgical treatment emphasizing, when possible, the total or near-total resection of the FBG must be performed to improve ASIA evolution.