From the Division of Facial Plastic Surgery (Dr Bassichis), Department of Otolaryngology–Head and Neck Surgery (Dr Thomas), University of Illinois at Chicago.
Hemostasis and decreased risk of synechiae formation are benefits of nasal packing after sinus surgery; however, these must be weighed against the possible complications, which can include devastating toxic shock syndrome. Nasal packing is often impregnated with an ointment that allows for a less traumatic placement into and removal from the nasal cavity, as well as providing some antibiotic coverage for nasal bacterial flora. Orbital complications secondary to the petroleum-based packing have been reported. When sinus surgery is performed in conjunction with a rhinoplasty, there is a possibility of petroleum ointment migrating into intranasal incisions or osteotomy sites. A 15-year-old girl was examined 1 year after endoscopic sinus surgery combined with an open rhinoplasty had been performed at another institution. Physical examination showed a widened nasal dorsum with an open-roof deformity and a 1-cm firm mass lateral to her lateral nasal sidewall. The pathological examination after removal of the cyst showed a foreign-body inclusion cyst or lipogranuloma. The cyst contained a petroleum-based substance.
Bassichis BA, Thomas JR. Foreign-Body Inclusion Cyst Presenting on the Lateral Nasal Sidewall 1 Year After Rhinoplasty. Arch Facial Plast Surg. 2003;5(6):530-532. doi:10.1001/archfaci.5.6.530