Complication of Using Bone Wax in Skull Base Surgery

Bone wax is a widely used nonabsorbable hemostatic agent that has few reported side effects. The limited case complications that are reported include granuloma formation, allergic reaction, infection, migration, and inhibition of bone healing. It is commonly used by orthopedists, cardiothoracic surgeons, neurosurgeons, otolaryngologists and dental surgeons due to its ease of use, availability, minimal adverse effects and efficiency at obtaining hemostasis. To date, there have been few cases reporting mucocele formation as a complication of using bone wax. Our case series highlights the potential long-term complications of mucocele formation in the sinuses associated with the use of bone wax in skull base surgery and we discuss the importance of exercising caution when using bone wax in sinus and skull base surgeries.