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... the patient also complained of recurrent headache, left nasal discharge and post nasal drip, the patient was referred to our OPD for evaluation and further management. Upon anterior rhinoscopic examination revealed mild septal deviation to right, hypertrophied inferior turbinates on both sides and purulent and foul-smelling discharge from left nostril but no foreign body or any other nasal pathology could be visualized. Left maxillary sinus tenderness could, also, be elicited. Oral cavity was examined for evidence of oroantral fistula but none could be found. A barely visible scar was seen over the face just below the left eye (Figure 1 and Figure 2). Syringing test revealed immediate and watery regurgitation from left eye. CT PNS (plain and contrast) re- vealed mucosal thickening of left maxillary sinus and multiple irregular foreign bodies, most probably glass par- ticles, in left maxillary sinus, blocking the left ostium. There was no evidence of any fistula or sinuses (Figure 3 and Figure ...
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case report for a man that applied for al lot of doctors with headache.
Background: Several approaches for the maxillary sinus were described. Currently, endoscopic Middle Meatal Antrostomy (MMA) is the gold standard for managing maxillary sinus lesions. Unfortunately, there are some limitations especially in hidden areas.
This research elucidates the advantages and disadvantages of adding IMF to the MMA for managing...
Foreign bodies are common to occur in the nose of children, but it is uncommon to be because of stabbing by open in the face. This paper will report a case of stabbing a child in the face that penetrate the maxillary sinus and nasal septum to the opposite side of the nose, where the pen tip is retained. Radiography was done to check the location of...
Citations
... Therefore, these injuries can remain underdiagnosed for years [7]. So far, removal by a transnasal endoscopic approach is the most preferred treatment option [8,9]. However, this approach might not be efficient in cases of large retained objects and an open technique through the anterior table of the frontal sinus might be necessary. ...
... When these injuries are not properly explored, retained foreign bodies can lead to sinocutaneous fistulas with nonspecific symptoms, such as headaches, nasal obstruction, and intermittent nasal hemorrhage [7]. When complicated, they may also cause improper drainage of the sinuses, secondary infections and sinusitis, or even inflammation of the dura [9]. To avoid those detrimental sequelae, a high index of suspicion is required and early removal is recommended. ...
Facial penetrating injuries can cause retention of foreign bodies in the frontal sinus. This rare condition can remain underdiagnosed for years, since non-specific symptoms, such as headaches and nasal obstruction, can be developed. So far, removal by an endoscopic approach is the most preferred treatment option because it is less invasive with a short recovery time. However, removal by an open surgical approach remains the method of choice for large foreign bodies, especially in cases of coexistent non-reducible fractures of the anterior table of the frontal bone. We present a case where a combined approach - open and endoscopic - was necessary to successfully remove a retained foreign body from a frontal sinus. With the assistance of a transnasal endoscope, the retained stone was mobilized and removed from the open frontal sinus followed by osteosynthesis of the anterior table. Therefore, in special circumstances, a combination of both techniques should be considered for the optimal outcome.
... The most common etiology of intrasinusal foreign bodies is iatrogenic in more than 60% of cases (dental, otorhinolaryngologic and ophthalmic procedures) or accidental in 25% of cases. The most commonly involved is the maxillary sinus (75%), followed by the frontal sinus (18%) 6,7 . Depending on the affected tooth, the most commonly involved is the first molar (22.51%), followed by the second molar (17.21%), the second premolar (2.2%) and the canines in 0.66% of cases. ...
Displacement of foreign bodies into the maxillary sinus is still a rare pathology, but the incidence is increasing continuously with the development of dental procedures. Most cases of foreign bodies are associated with dental procedures. These can be of varying natures, such as dental implants, fractured teeth roots, endodontic materials and tools, dental burs, dental impression materials or dental fillings materials. Less frequent are the foreign bodies of non-dental origin, which are related to facial injuries in accidents or assaults. The diagnosis is based on careful clinical and radiological examinations. Foreign bodies should be diagnosed and treated on time in order to prevent complications, mainly acute or chronic rhinosinusitis.
In this article, we review the main characteristics regarding the incidence, etiology, diagnosis and treatment options – endoscopic and an external approach for the removal of a displaced foreign body into the maxillary sinus. Also, we present our personal experience and treatment options, highlighting the importance of pre-operative evaluation, proper imaging assessment, adequate access and visibility and adequate surgical technique, in order to prevent later sinonasal infectious complications.
... The traumatic causes can be classified as accidental or iatrogenic [7]. The presence of pieces of glass [8], a ballpoint pen [9], and multiple wood and plastic pieces [10] are considered accidental causes. ...
Patient: Male, 32-year-old
Final Diagnosis: Foreign body in maxillary sinus
Symptoms: Blindness • eye bleeding • eye pain • history of trauma
Medication: —
Clinical Procedure: Caldwell-Luc
Specialty: Otolaryngology
Objective
Unusual clinical course
Background
Paranasal sinus foreign bodies are rarely encountered in otolaryngology practice.
Case Report
We present the case of a 32-year-old man who presented to our Emergency Department with his left eye bleeding after a nail gun injury. The initial physical examination revealed the presence of a left eye ruptured globe, which led to left eye blindness. An urgent plain X-ray scan was done, in which the presence of a metallic object impacted in the left maxillary sinus was demonstrated. The patient was managed surgically by an external approach using the Caldwell-Luc procedure, with no intra- or postoperative complications.
Conclusions
Paranasal sinus foreign bodies, if improperly treated, can cause serious morbidity. Surgical removal, either endoscopically or through an external approach, is required.
... Its occurrence within the paranasal sinuses may remain unrecognized for a significant duration of time as compared to other region of the body(1). Majority of foreign bodies are reported to be identified from maxillary sinus (75%) followed by frontal sinus (18%) as compared to sphenoid and ethmoidal sinus (2). It is noteworthy that foreign body easily gets displaced into the maxillary sinus due to its low density of bone along with its anatomical condition, resorption of bone, intranasal pressure changes, severe atrophy and occasionally due to iatrogenic causes (3). ...
Foreign body in paranasal sinus is relatively uncommon in adults unlike in pediatrics cases. Majority of foreign bodies in the paranasal sinus are reported to be identified from maxillary sinus (75%), followed by frontal sinuses (18%), finally sphenoid and ethmoidal sinuses. A 34-year-old gentleman with 1-year-history of accidental dislodged screw during a dental surgery presented with unilateral nasal symptoms. To our surprise, computed tomography paranasal sinus revealed opacity in the right sphenoid sinus when the initial screw was missing from the left side. Albeit a rare entity, awareness amongst physician on migration of foreign body is crucial as it may ascribe to devastating consequences. ÖZET Paranazal sinüsteki yabancı cisim, pediatri vakalarından farklı olarak yetişkinlerde nispeten nadirdir. Paranazal sinüsteki yabancı cisimlerin çoğunun maksiller sinüsten (% 75) ve ardından frontal sinüslerden (% 18), son olarak sfenoid ve etmoidal sinüslerden tanımlandığı bildirilmektedir. Bir diş cerrahisi sırasında 1 yaşında kazara yerinden çıkmış vida öyküsü olan 34 yaşında bir beyefendi, tek taraflı burun semptomları ile başvurdu. Bizim için sürpriz olan bilgisayarlı tomografi paranazal sinüs, ilk vida sol taraftan eksik olduğunda sağ sfenoid sinüste opasite gösterdi. Nadir bir varlık olsa da, hekimin yabancı cismin göçü konusundaki farkındalığı, yıkıcı sonuçlara yol açabileceğinden çok önemlidir.
