Foreign-body reaction to silastic burr-hole covers with seroma formation: Case report and review of the literature

Because silastic material is one of the most commonly used biomaterials in modern medicine, the biocompatibility of these implants is still a source o f long standing controversy. Though several studies have established silast ic material as biologically inert, numerous authors have repeatedly describ ed characteristic pathological tissue responses to silicone and its elastom eres. We report a case of foreign-body reaction to silastic burr-hole cover with successive formation of a seroma following resection of an olfactory groove meningioma. Within 30 days postoperatively, the patient developed a marked bulge in the glabbelar region. Histopathological examination revealed a seroma-like lesion obviously cause d by a chronic inflammatory allergic reaction to the silastic burr-hole cov er. Although the silicone-induced tissue damage clinically shows a wide variabi lity and a conclusive model of pathogenesis is presently not available, the histopathological findings in some patients, in the form of,granulomatous lesions and inflammatory cell response, might partly be due to an immunolog ical reaction. Such a reaction has been previously described both clinicall y and experimentally, as detected in our patient. In addition, a review of the literature is given.