안면부 골절에 사용된 흡수성 보형물의 지연성 이물반응: 증례보고

Delayed Foreign Body Reaction around the Absorbable Implants in Facial Bone Fracture: A Case Report

  • 서용훈 (인제대학교 상계백병원 성형외과학교실) ;
  • 김영준 (인제대학교 상계백병원 성형외과학교실)
  • Suh, Yong-Hoon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Young-Joon (Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Inje University College of Medicine)
  • 투고 : 2011.06.28
  • 심사 : 2011.09.16
  • 발행 : 2011.11.10

초록

Purpose: Absorbable implants are frequently used to fix facial bone fractures, because they are radiolucent and compatible with magnetic resonance imaging (MRI). Despite their increasing usage, however, there have been few reports about their long-term side-effects. In this paper, a case in which absorbable implants led to a foreign body reaction 17 months after their insertion is presented. Methods: A previously healthy 19-year-old male fell from a flight of stairs and visited the authors' hospital with right periorbital pain. Zygomaticomaxillary fracture involving right orbital floor was detected via a facial bone computed tomography (CT). Internal fixation with absorbable implants was followed by open reduction. 17 months after the surgery, the patient complained of localized periorbital swelling. Removal of the granulomatous lesion including the absorbable implants along with their biopsy and culture was performed. Results: The granulomatous lesion around the implants was firm and extended into the maxillary sinus. The histologic finding showed a microabscess with a foreign body reaction. Methicillin-sensitive Staphylococcus aureus growth was confirmed in the culture. No definite abnormal symptoms ensued after the complete removal. Conclusion: A microabscess-forming granulomatous lesion around the absorbable implant can cause delayed symptomatic foreign body reaction despite its rare occurrence. Complete removal of the lesion including implants is expected to have a successful outcome if it is encountered.

키워드

참고문헌

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