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Chronic, Symptomatic Orbital Inflammation Resulting From Retained Bone Wax
Loka Thangamathesvaran1, Neena Mirani1,2, Roger Turbin1
1Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School.
Ophthalmic Plastic and Reconstructive Surgery
|October 9, 2019
Summary
A chronic inflammatory reaction to bone wax, a surgical material, caused a persistent draining wound and eye inflammation in a patient after orbital surgery. Prompt removal of the bone wax led to symptom resolution, highlighting its potential as a foreign body.
Area of Science:
- Ophthalmology
- Surgical Pathology
Background:
- Orbital surgery, such as lateral orbitotomy, can be complicated by post-operative inflammatory reactions.
- Bone wax is a hemostatic agent used in surgery, but its long-term biocompatibility in the orbit is not well-established.
Observation:
- A 58-year-old man presented with a 9-month history of a draining surgical wound and periorbital inflammation after a right lateral orbitotomy.
- MRI revealed a characteristic lesion in the right lateral orbit, appearing hypointense on T1- and T2-weighted images with peripheral enhancement.
Findings:
- Biopsy confirmed a chronic foreign body inflammatory reaction to bone wax.
- Surgical removal of the retained bone wax resulted in complete resolution of the patient's symptoms.
Implications:
- This case underscores the potential for bone wax to elicit a delayed foreign body inflammatory response in the orbit.
- Ophthalmologists and orbital surgeons should consider retained bone wax in the differential diagnosis of chronic inflammatory conditions following orbital procedures.
- Further investigation into the long-term safety and inflammatory potential of bone wax in delicate anatomical spaces like the orbit is warranted.
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