Experimental Myospherulosis of the Paranasal Sinuses: A Histologic Rabbit Study

Abstract

Myospherulosis or lipogranuloma formation is frequently iatrogenic and is caused by a petrolatum, lanolin, or paraffin-based ointment becoming trapped within tissue. Four different ointments, including the newly available Bactroban nasal, were studied in a rabbit paranasal sinus model to evaluate their proclivity to induce myospherulosis. The maxillary sinuses of 16 New Zealand white rabbits were bilaterally inoculated with Bactroban, Bactroban nasal, tetracycline, or bacitracin ointments and compared to saline controls in two rabbits. Sinus specimens were harvested at 2 and 4-week intervals and processed for histologic study. Myospherulosis formation was uniformly induced with the Bactroban nasal, bacitracin, and tetracycline ointments in 8/8, 7/8, and 8/8 sinuses, respectively. In contrast, myospherulosis was not induced in the 5/8 of the sinuses using Bactroban. The data from this investigation indicate that Bactroban nasal (paraffin vehicle) is similar to bacitracin and tetracycline ointments (petrolatum and petrolatum-lanolin vehicles) in that they all can cause myospherulosis. In contrast, Bactroban (a water-soluble, polyethylene glycol base) causes myospherulosis to a much smaller extent. Our results emphasize the differences between the two types of Bactroban preparations and provide objective data that can be evaluated by otolaryngologists who apply these ointments following nasal cavity surgery.