Delayed inflammatory response evoked in nasal alloplastic implants after COVID-19 vaccination: A case report

doi:10.12998/wjcc.v10.i23.8298

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World Journal of Clinical Cases

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Case Report

World J Clin Cases. Aug 16, 2022; 10(23): 8298-8303
Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8298

Delayed inflammatory response evoked in nasal alloplastic implants after COVID-19 vaccination: A case report

Min-Gi Seo, Eun Kyung Choi, Kyu Jin Chung

Min-Gi Seo, Kyu Jin Chung, Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea

Eun Kyung Choi, Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu 42415, South Korea

Author contributions: All authors contributed to the case conception and design; Chung KJ provided the valuable case and performed the operation; data collection and analysis were performed by Seo MG; the first draft of the manuscript was written by Seo MG; all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript.

Supported by

the 2016 Yeungnam University Research Grants.

Informed consent statement: A written informed consent was obtained from the patient for publication of this case report.

Conflict-of-interest statement: The authors have nothing to disclose.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Kyu Jin Chung, MD, PhD, Associate Professor, Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, 170, Hyeonchung-ro, Daegu 42415, South Korea. chungkj@ynu.ac.kr

Received: February 6, 2022
Peer-review started: February 6, 2022
First decision: May 30, 2022
Revised: June 9, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 16, 2022
Processing time: 175 Days and 15.7 Hours

Abstract

BACKGROUND

Delayed inflammatory reactions (DIRs) in alloplast rhinoplasty are a rare complication that may occur several months to years after surgery. The exact causes and mechanisms are unclear, but several triggering factors, including infections, trauma, dental procedures, and vaccination, have been reported.

CASE SUMMARY

A 39-year-old male patient who had undergone augmentation rhinoplasty 8 years ago had DIRs after the administration of the first dose of the mRNA Pfizer coronavirus disease 2019 (COVID-19) vaccine. He suddenly had tender, erythematous swelling on his face 6 d after vaccination. As there was no improvement in the patient’s condition after the conservative treatment, surgical removal of an alloplastic nasal implant was performed. Immediately after the surgery, the DIRs and accompanying symptoms ameliorated rapidly. A histological study conducted during surgery was fibrosis and small fragments of the hyaline cartilage.

CONCLUSION

The correlation between DIRs and COVID-19 vaccination has not been reported yet and the exact mechanism is unclear. Because the uncontrolled inflammatory reactions on the nose leave serious sequelae, surgeons should be conscious of the correlation between COVID-19 vaccines and DIRs associated with nasal alloplastic implants. And further histological or microbiological studies should be performed to determine the cause of DIRs.

Keywords: Delayed inflammatory reactions; Alloplast rhinoplasty; Silicone; COVID-19; Vaccination; Case report

Core Tip: Delayed inflammatory reactions (DIRs) in alloplast rhinoplasty are rare and their correlation with coronavirus disease 2019 (COVID-19) vaccines is unclear. We present herein the first case of DIRs in alloplast rhinoplasty after the first administration of the COVID-19 vaccine. We performed surgical removal of an alloplastic implant because no improvements were observed in the patient’s condition after conservative treatment. This intervention accelerated recovery. A delayed fibrotic reaction induced by the COVID-19 vaccine may be a possible cause. Our case suggests surgeons should be aware of the correlation between COVID-19 vaccines and DIRs in alloplast rhinoplasty.