oxytetracycline--anhydrous and Foreign-Body-Reaction

Sinonasal myospherulosis is a foreign body reaction to lipid material used on nasal packing at the conclusion of paranasal sinus surgery. Rare cases have been sporadically reported. We report a case found in a 79-year-old female 8 months after functional endoscopic sinus surgery during which sinus cavities had been packed with gauze coated with Terra-Cortril (a paraffin-based tetracycline/steroid ointment). The preoperative diagnosis was suggested during CT of the paranasal sinuses by the presence of macroscopic paraffin retention cysts having a characteristic fat density. To our knowledge, our case represents the first report of sinonasal myospherulosis suggested by CT.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents; Cysts; Drug Combinations; Endoscopy; Female; Foreign-Body Reaction; Humans; Hydrocortisone; Middle Aged; Ointment Bases; Ointments; Oxytetracycline; Paraffin; Paranasal Sinus Diseases; Paranasal Sinuses; Sinusitis; Tomography, X-Ray Computed

A case of myospherulosis, a condition first reported in 1969, is reported following the extraction of mandibular third molars and subsequent placement of Terra-Cortril and Gelfoam into the extraction sites. The lesions were discovered during a periodontal surgical procedure and to the best of our knowledge this is the first such report in the periodontal literature.

Topics: Administration, Topical; Adolescent; Anti-Inflammatory Agents; Drug Combinations; Female; Foreign-Body Reaction; Gelatin Sponge, Absorbable; Humans; Hydrocortisone; Mandibular Diseases; Molar, Third; Oxytetracycline; Tooth Extraction

Myospherulosis is a recently discovered disease apparently caused by the placement of mineral oil- or petrolatum-based products into various tissues. Terra-Cortril (a tetracycline/steroid ointment in a petrolatum base) on Gelfoam has been placed in the sockets of surgically removed third molars in an attempt to eliminate the occurrence of dry sockets. The case report presented here documents the radiographic progress of the disease for 6 years, showing an attempt by the bone to repair itself. A surgical procedure was performed to remove the affected tissue, and photographs were taken to illustrate the clinical appearance of the disease. The specimen consisted of a black, tarlike material which was completely encased in bone. Histologic examination was consistent with a diagnosis of myospherulosis.

Topics: Administration, Topical; Alveolar Process; Anti-Inflammatory Agents; Drug Combinations; Erythrocytes, Abnormal; Foreign-Body Reaction; Gelatin Sponge, Absorbable; Humans; Hydrocortisone; Mandibular Diseases; Oxytetracycline; Spherocytes

Myospherulosis is a unique, inflammatory, granulomatous lesion, which results from the action of lipid substances on extravasated erythrocytes. Petrolatum-based antibiotic ointments are the most frequent etiologic agents of iatrogenically acquired lesions. Six intraoral cases of myospherulosis are presented, including the first reported case in oral soft tissues. The literature of reported cases is summarized and the epidemiology, histopathology, and ultrastructure of the lesions are discussed. Predisposing events and recommendations for future use of petrolatum-based antibiotic ointments are presented.

Topics: Administration, Topical; Adolescent; Adult; Aged; Anti-Inflammatory Agents; Drug Combinations; Erythrocytes, Abnormal; Female; Foreign-Body Reaction; Gingival Diseases; Humans; Hydrocortisone; Male; Mandibular Diseases; Ointment Bases; Oxytetracycline; Petrolatum; Spherocytes