The term “gossypiboma” refers to a mass of the cotton matrix that is left in the body following an operation. It can remain silent postoperatively and appear several years later with a variety of symptoms or non-specific radiological findings. In addition, gossypiboma that persists in the human body for a long time can cause many complications when surgically removed. We report the case of a 33-year-old man who underwent rhinoseptoplasty and presented with nasal obstruction by a foreign body sensation. On endoscopic examination, protruding fabric material and granulation tissue were detected in the medial portion of the left nasal septum. Severe adhesion between the gossypiboma and septal mucosa resulted in a significant defect in the septal mucosa after endoscopic removal. The septum was approximated and reconstructed using a posterior-based inferior turbinate flap. The nasal obstruction completely resolved after surgery, and the septum healed at the six-month follow-up. This case emphasizes the possibility of gossypiboma when missing gauze remains in the patient after rhinoseptoplasty and a large septal perforation occurs as a consequence of gossypiboma removal. Rhinoplasty surgeons should be cautious to prevent materials being left inside the patient and efficiently follow-up on patients with nonspecific postoperative complaints.

Keywords: foreign bodies, gossypiboma, nasal septal perforation, nasal septum, reconstruction, rhinoplasty

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