Granulomatous foreign body reaction in tip and nasal dorsum due to filling materials. Presentation of a clinical case and review of the literature

Abstract

A 29-year-old patient with a history of three nasal fillings in the nasal tip with hya- luronic acid five years ago, reason for consultation improvement nasal aesthetics and nasal obstruction. Physical examination showed a slight osteocartilaginous hump, bul- bous tip, symmetrical nostrils, no deviation nasal pyramid, no masses or nodules were palpated. After the management of his rhinitis and previous informed consent, when performing open rhinoseptoplasty, a large amount of foreign body type granulation tis- sue was found in the tip and nasal dorsum, which forced the surgical plan to change. The post-surgical biopsy showed foreign body granuloma by biopolymer derived from silicone. Evolved satisfactorily aesthetically and functionally. The use of nasal fillers has increased in recent years, although there are no facial fillers approved by the FDA for nasal use. The correct use of nasal fillers is a controversial issue. Nasal granulomas by foreign body are late complications that have increased with the use of biopolymers with inadequate doses and techniques. The use of ecotomography has contributed to improve the surgical planning; the deferred histological study has allowed to identify the material used in most cases becoming the gold standard