Infratemporal Gossypiboma Presenting as Persistent Infection After Third Molar Displacement: Diagnostic Considerations

Abstract

Gossypiboma refers to a foreign-body reaction caused by the inadvertent retention of surgical materials—such as gauze, cotton swabs, or pads—within an operative site. It results from a foreign body inflammatory response that may be aseptic or associated with secondary infection. This case report describes a 30-year-old woman who developed a persistent orofacial infection resulting from a retained surgical gauze (gossypiboma) following the displacement of a third molar into the infratemporal space. Diagnosis was challenging due to the rarity of this condition in oral and maxillofacial surgery, and initial treatments—including tooth retrieval, abscess drainage, and antibiotic therapy—failed to resolve the infection. Computed tomography (CT) revealed a characteristic spongiform gas pattern adjacent to the lesion, raising suspicion of a retained foreign body. During subsequent surgical exploration, the retained foreign body was identified and successfully removed. This report underscores the importance of considering gossypiboma in the differential diagnosis of persistent postoperative infections and highlights the necessity of strict surgical protocols to prevent such occurrences.