Cholesterol granuloma of the facial skeleton

Abstract

The radiological features of 24 patients with cholesteral granuloma affecting the facial skeleton are described. They occurred at two sites: (a) in the maxillary antrum (nine patients) and (b) in the frontal bone, affecting the superolateral orbital wall and adjacent soft tissues (15 patients). The radiographic features of the antral cholesterol granuloma were of two types: a variety in which the changes were entirely nonspecific and could not be differentiated from inflammatory or allergic sinus disease, and a more characteristic appearance of a cyst-like lesion within the sinus cavity accompanied by expansion of the bony walls of the antrum involved. The radiographic changes encountered in the cholesterol granuloma of the frontal bone were more specific and were best demonstrated by plain radiography. The typical radiological picture was that of a clear-cut area of osteolysis in the lateral part of the supraorbital ridge and frontal bone, characteristically extending into the zygomatic process as far as the fronto-malar suture. This change is regarded as being diagnostic of a cholesterol granuloma in this situation.