Sigron Guido R, Locher Michael C
Department of Oral Surgery, Center for Dental and Oral Medicine and Cranio-Maxillofacial Surgery, University of Zurich, Plattenstrasse 15, 8032 Zurich, Switzerland.
J Med Case Rep. 2011 May 28;5:211. doi: 10.1186/1752-1947-5-211.
Gossypiboma (foreign body granuloma) in the tooth socket as a complication of tooth removal is rare. Several cases of gossypiboma have been reported after orthopedic, abdominal, otorhinolaryngology, or plastic surgery, but there has been only one reported case after oral surgery.
A 42-year-old Caucasian German-speaking Swiss woman applied to our clinic for removal of her right mandibular first molar. Her right mandibular third molar had been removed seven years ago. Post-operatively, she complained of pain and foreign body sensation for six months in the area of the removed tooth. A panoramic radiograph of our patient showed a defined and oval radiolucent area in the socket of the right mandibular third molar evoking a residual cyst. An operation was planned to remove the cyst-like lesion. During surgery, a foreign body composed of gauze was found in the right mandibular third molar region. The histological findings were compatible with a foreign body reaction around gauze.
Retained gauze must be considered if patients complain of pain and foreign body sensation after tooth removal. The use of gauze with radio-opaque markers and extensive irrigation of the socket with saline to remove gauze fragments can avoid this mishap.
拔牙后牙槽窝内棉绒瘤（异物肉芽肿）作为一种并发症较为罕见。已有多例棉绒瘤在骨科、腹部、耳鼻喉科或整形手术后被报道，但口腔手术后仅有一例报道。
一名42岁讲德语的白种瑞士女性因右下颌第一磨牙拔除前来我院就诊。她的右下颌第三磨牙在七年前已被拔除。术后，她在拔牙区域出现疼痛和异物感达六个月。患者的全景X线片显示右下颌第三磨牙牙槽窝内有一个边界清晰的椭圆形透射区，提示残留囊肿。计划进行手术切除囊肿样病变。手术过程中，在右下颌第三磨牙区域发现了一块由纱布构成的异物。组织学检查结果与纱布周围的异物反应相符。
如果患者在拔牙后出现疼痛和异物感，必须考虑有纱布残留的可能。使用带有不透射线标记的纱布以及用生理盐水对牙槽窝进行充分冲洗以清除纱布碎片可避免此类意外发生。
