Foreign body granuloma due to retained surgical sponge is also called gossypiboma. Only one case of nasal septum gossypiboma has been reported.
In this report, we present a case of retained surgical sponge at the septoplasty site.
A 16-year-old male patient came to our emergency department complaining of nasal obstruction associated with low-grade fever. With past history of septoplasty 3 months ago. Endoscopic examination of the nasal cavity revealed bilateral smooth swelling of the nasal septum, no fluid was detected with aspiration. A CT scan of the nose and paranasal sinuses revealed significant posterior septal swelling. A consent had been taken from the parents, and the patient was prepared for endoscopic exploration under general anesthesia. Elevation of bilateral mucoperichondrial and mucoperiosteal flaps was done. There was a firm swelling with intense reaction all around, after meticulous dissection of this lesion and was delivered with Blakesley forceps. On closer examination it was a missed cotton ball. The patient follow-up for 12 months was excellent with complete disappearance of his complaints.
Retained surgical items should be considered in the differential diagnosis of post-operative nasal septum swellings. Sponges used for nasal surgery should be of appropriate size and attached to a thread and should be counted.