J Rhinol.  2022 Jul;29(2):101-105. 10.18787/jr.2021.00369.

A Case of Nasal Septum Gossypiboma 14 Years After Septorhinoplasty

• Yang S
• Bae S
• Seo J
• Cho HJ
• Kim CH
• Ha JG

• KMID: 2532012
• DOI: http://doi.org/10.18787/jr.2021.00369

Abstract

Gossypiboma, an infrequent surgical complication, describes a mass of cotton material inadvertently left in the body cavity after an operation. It is an extremely rare iatrogenic complication of nasal surgery, with only a few cases reported in literature to date. Here we present a case of gossypiboma in the nasal septum of a 35-year-old male patient who previously underwent septorhinoplasty fourteen years prior. He was treated by endoscopic endonasal surgery to remove the lesion. Pathologic findings showed a foreign body (gauze filament) with a giant cell reaction. This report will be helpful for treating patients with similar histories in the future.

Keyword

Gossypiboma, septorhinoplasty, foreign body, endoscopic endonasal surgery

Figure

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  Fig. 1 Endoscopic images of nasal cavity. A: Foreign body (gauze filament) is noted in the right nasal septum with adhesions. B: The left nasal cavity is clear. C: Foreign body (gauze filament) is imbedded in the septal cartilage with severe adhesion resulting in difficulty of removing through submucoperichondrial dissection. D: Septal cartilage was included in the total resection of the lesion. E, F: The septal mucosa is in a well-healed status without septal perforation at 1 month (E) and 3 months (F) after the surgery.

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  Fig. 2 Preoperative CT and MRI findings of the lesion. CT (A) and MRI (B–D) show an infiltrative lesion in the right side of nasal septum. The lesion (arrow) shows low-signal intensity on T1-weighted image (B) and T2-weighted image (C), without enhancement on contrast-enhanced T1-weighted image (D). MRI findings show an intact mucosa and perichondrium on the contralateral side of the lesion. CT, computed tomography; MRI, magnetic resonance imaging

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  Fig. 3 Microscopic finding. Foreign body (gauze filament) surrounded by inflammation and foreign-body giant cell reaction (hematoxylineosin, original magnification ×100 [A], ×400 [B]).

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