{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:03:25Z","timestamp":1773929005936,"version":"3.50.1"},"reference-count":20,"publisher":"Pensoft Publishers","issue":"2","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FM"],"abstract":"<jats:p>Cholesterol granulomas and cysts represent uncommon pathological findings in the paranasal cavities; however, they have also been documented in other areas, including the orbit, the petrous part of the temporal bone, and the nasal septum, among others. Histologically, they are composed of granulation tissue and a significant quantity of cholesterol crystals. The etiology of the disease is primarily associated with microtraumas in the affected structures, which result in the rupture of small blood vessels. This phenomenon leads to the accumulation of formed elements and cholesterol in the affected regions, resulting in the formation of a foreign-body-type granuloma that gradually increases in size. The process is both expansive and destructive, characterized by gradual and painless development.<\/jats:p>\n                  <jats:p>The primary objective of this study was to direct the attention of attending physicians to this rare but existing pathology. The following two clinical cases are presented: they pertain to patients with histologically confirmed cholesterol granuloma, which initially manifested with complaints related to an affected orbit. Patient 1 underwent endoscopic endonasal surgery, yet the disease persisted. Conversely, patient 2 underwent a combined approach, yielding excellent results.<\/jats:p>\n                  <jats:p>Cholesterol granulomas are a rare pathological entity with a poorly understood etiology. The diagnosis is confirmed through pathological verification. Surgical intervention remains the most effective treatment for cholesterol granulomas in the paranasal cavity region. An accurate diagnosis and effective collaboration among different medical units\u2014including the surgical team, imaging diagnostics, and pathology\u2014are essential for comprehensive treatment.<\/jats:p>","DOI":"10.3897\/folmed.68.e149538","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:50:47Z","timestamp":1773917447000},"source":"Crossref","is-referenced-by-count":0,"title":["Periorbital cholesterol granulomas\/cysts \u2013 two clinical cases presentation"],"prefix":"10.3897","volume":"68","author":[{"given":"Karen","family":"Dzhambazov","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria, Plovdiv, Bulgaria"},{"name":"Department of Otorhinolaryngology, St George University Hospital, Plovdiv, Bulgaria, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stoyan","family":"Markov","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, St George University Hospital, Plovdiv, Bulgaria, Plovdiv, Bulgaria"},{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-365X","authenticated-orcid":true,"given":"Aleksandrina","family":"Topalova-Shishmanova","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria, Plovdiv, Bulgaria"},{"name":"Department of Otorhinolaryngology, St George University Hospital, Plovdiv, Bulgaria, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgi","family":"Georgiev","sequence":"additional","affiliation":[{"name":"MHAT \"ST ST Kozma i Damian\"; ENT Department, Plovdiv, Bulgaria"},{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantin","family":"Giritliev","sequence":"additional","affiliation":[{"name":"MHAT \"ST ST Kozma i Damian\"; ENT Department, Plovdiv, Bulgaria"},{"name":"Department of Otorhinolaryngology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7678-5703","authenticated-orcid":true,"given":"Elizabet","family":"Dzhambazova","sequence":"additional","affiliation":[{"name":"Medical University of Plovdiv; Faculty of public Health; Department of Social Medicine and Public Health, Plovdiv, Bulgaria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2258","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"149538_B1"},{"key":"149538_B2"},{"key":"149538_B3"},{"key":"149538_B4"},{"key":"149538_B5"},{"key":"149538_B6"},{"key":"149538_B7"},{"key":"149538_B8"},{"key":"149538_B9"},{"key":"149538_B10"},{"key":"149538_B11"},{"key":"149538_B12","doi-asserted-by":"crossref","unstructured":"Loeffler KU, Kommerell G. Cholesterol granuloma of the orbit \u2013 pathogenesis and surgical management. Int Ophthalmol 1997; 21:93\u20138. doi.\/10.1023\/A:1005838915787","DOI":"10.1023\/A:1005838915787"},{"key":"149538_B13"},{"key":"149538_B14"},{"key":"149538_B15"},{"key":"149538_B16"},{"key":"149538_B17"},{"key":"149538_B18"},{"key":"149538_B19"},{"key":"149538_B20"}],"container-title":["Folia Medica"],"original-title":[],"link":[{"URL":"https:\/\/foliamedica.bg\/article\/149538\/download\/pdf\/","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article\/149538\/download\/xml\/","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/foliamedica.bg\/article_preview.php?id=149538&skip_redirect=1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T10:50:49Z","timestamp":1773917449000},"score":1,"resource":{"primary":{"URL":"https:\/\/foliamedica.bg\/article\/149538\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,19]]},"references-count":20,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,3,19]]}},"URL":"https:\/\/doi.org\/10.3897\/folmed.68.e149538","relation":{},"ISSN":["1314-2143","0204-8043"],"issn-type":[{"value":"1314-2143","type":"electronic"},{"value":"0204-8043","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,19]]},"article-number":"e149538"}}