Gossypiboma following mandible surgery: a case report and review of the literature

Abstract

Background: Gossypiboma, a foreign-body granuloma induced by a retained surgical sponge, has rarely been reported in relation to the facial bones. The aim of this article is to draw attention to this potentially serious complication. Case presentation: A 37-year-old Middle Eastern female reported to the clinic because of pain, mild swelling and paraesthesia in the anterior mandible area. Her symptoms started 2 years earlier shortly after chin implant surgery that was complicated by a local infection requiring removal of the implant. On clinical examination, there was mild swelling and tenderness in the anterior mandible region. A panoramic radiograph, a computed tomography (CT) scan and magnetic resonance imaging (MRI) showed bilateral well-defined cystic lesions in the parasymphyseal area of the mandible. The patient underwent trephine bone biopsy followed by complete excision of the lesion. Histopathological examination revealed foreign-body granuloma with foreign bodies consistent with gauze, typical findings of gossypiboma. The patient made unremarkable post-operative recovery and her preoperative symptoms subsided completely. Conclusion: Gossypiboma is a rare complication of mandibular surgery. It should be considered in patients with persistent post-operative complaints. CT scan and MRI are the imaging methods of choice in suspected cases. Complete surgical excision is adequate to alleviate the patient's symptoms.

Maxillofacial Gossypiboma: Case Report, Review of the Literature, and Diagnosis Algorithm

“…Gossypiboma is a term used for a retained surgical sponge, and it represents a rare complication [1][2][3] with an uncertain incidence probably due to medical-legal implications [2,4]. The word is derived from the combination of the Latin word 'gossypium' for 'cotton' and the Swahili word 'boma' for 'place of concealment' [2][3][4][5].…”

“…Gossypiboma is a term used for a retained surgical sponge, and it represents a rare complication [1][2][3] with an uncertain incidence probably due to medical-legal implications [2,4]. The word is derived from the combination of the Latin word 'gossypium' for 'cotton' and the Swahili word 'boma' for 'place of concealment' [2][3][4][5]. It can be defined as a mass within the body composed of cotton matrix, which usually refers to a forgotten wound dressing surrounded by a foreign body reaction [4,5].…”

“…The word is derived from the combination of the Latin word 'gossypium' for 'cotton' and the Swahili word 'boma' for 'place of concealment' [2][3][4][5]. It can be defined as a mass within the body composed of cotton matrix, which usually refers to a forgotten wound dressing surrounded by a foreign body reaction [4,5]. While the medical literature has previously described cases of this entity after surgery procedures, gossypibomas in oral and maxillofacial region are rare [2].…”

“…Postoperative complications of forgotten surgical gauzes may occur at any time in the postoperative period [3], and clinically this situation may be associated with persistent bleeding and infection discharge [4,6]. In some cases, the missed surgical gauze can be accidentally found before the onset of signs and symptoms.…”

“…In some cases, the missed surgical gauze can be accidentally found before the onset of signs and symptoms. Although there are no pathognomonic features of a foreign body reaction in oral and maxillofacial region, the most common symptoms suggestive of persistent inflammation include pain, fever, swelling, surgical wounds that do not heal, and purulent drainage [4,5].…”