Unique Case of Gossypiboma following Treatment of the Orbitozygomatic Complex Fracture


1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz

2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran


Transmaxillary approach to the orbital floor has been used successfully to treat the blowout fracture by antral packing to support the orbital floor.
However, antral packs are associated with a high incidence of infection and persistent oroantral fistula. A 30‑year‑old man with a history of the
orbitozygomatic complex fracture 8 years ago presented with a persistent facial wound on the right side of the cheek. The patient underwent
an exploratory surgery under general anesthesia, and the maxillary sinus was approached through the Caldwell‑Luc operation and a long
2‑m nasal tampon was found in the sinus. Foreign bodies including gossypibomas are rare, hard to diagnose, and mostly asymptomatic and
in chronic cases do not reveal specific radiological and clinical signs for differential diagnosis. Therefore, in the evaluation of the soft‑tissue
lesions in patients with a history of a prior operation, it is wise to consider foreign bodies in the differential diagnosis.


1. Matsuda Y, Sakaida H, Kobayashi M, Takeuchi K. Successful application
of endoscopic modified medial maxillectomy to orbital floor trapdoor
fracture in a pediatric patient. Auris Nasus Larynx 2016;43:575‑8.
2. Walter WL. Early surgical repair of blowout fracture of the orbital floor
by using the transantral approach. South Med J 1972;65:1229‑43.
3. Park MW, Kim SM, Amponsah EK, Lee SK. Simple repair of a
blow‑out fracture by the modified caldwell‑luc approach. J Craniofac
Surg 2015;26:e306‑7.
4. Finlay PM, Ward‑Booth RP, Moos KF. Morbidity associated with the use
of antral packs and external pins in the treatment of the unstable fracture
of the zygomatic complex. Br J Oral Maxillofac Surg 1984;22:18‑23.
5. Sahin YF, Muderris T, Bercin S, Sevil E, Kırıs M. Chronic maxillary
sinusitis associated with an unusual foreign body: A case report. Case
Rep Otolaryngol 2012;2012:903714.
6. Pagella F, Emanuelli E, Castelnuovo P. Endoscopic extraction
of a metal foreign body from the maxillary sinus. Laryngoscope
7. Lata I, Kapoor D, Sahu S. Gossypiboma, a rare cause of acute
abdomen: A case report and review of literature. Int J Crit Illn Inj Sci