Endoscopic Transnasal Management of Intracranial Foreign Bodies

Dodson, Kelley M.; Bridges, Matthew A.; Reiter, Evan R.

doi:10.1001/archotol.130.8.985

Cited by 27 publications

(27 citation statements)

References 15 publications

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“…To investigate the injury of intracranial arterial and venous system, cerebral angiography is quite helpful. 2 In the present case, no vascular structures were involved.…”

Section: Technical Strategymentioning

confidence: 42%

“…1 External approach by craniotomy is typically accepted, but it carries significant morbidities. 2 Recently, transnasal endoscopic removal of intracranial foreign body has been reported. 2Y4 We experienced a case of transnasal intracranial penetrating metallic chopstick, which was removed successfully by endoscopic approach, and management of transnasal intracranial penetrating injuries, including its prerequisites for endoscopic removal, is discussed with a review of literature.…”

mentioning

confidence: 99%

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Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Lee

Seo²,

Lim³

2011

Journal of Craniofacial Surgery

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“…To investigate the injury of intracranial arterial and venous system, cerebral angiography is quite helpful. 2 In the present case, no vascular structures were involved.…”

Section: Technical Strategymentioning

confidence: 42%

mentioning

confidence: 99%

Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Lee

Seo²,

Lim³

2011

Journal of Craniofacial Surgery

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“…The natural history of FB intrusion in the paranasal sinuses is not completely known;4 it may occur through a variety of traumatic or iatrogenic events and it is important to remove FBs from paranasal sinus even when they are asymptomatic 2 5. FBs in the paranasal sinuses may trigger inflammation, infection or malignant changes in the mucosa;5 other reported complications include chronic pain, cutaneous fistula, rhinolith formation and chronic sinusitis,4 however, the weight, size and chemical composition of the FB is a determinant of the complications 6.…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, a transnasal endoscopic approach which has been successful in retrieval of smaller FBs in paranasal sinuses;10 however, the method of removal depends on size and location of the FB and the surgeon's preference. In some cases, especially in fragmented FBs, a combined approach of open surgery and endoscopic approach may be used to completely remove all fragmented parts 2. The surgical technique used in this case was unusual because the tip of the long narrow metal rod was visible just beneath the check skin and its surface was smooth, hence we preferred to remove it simply by pulling it from skin to minimise injury to the nose, sinus and facial structures.…”

Section: Discussionmentioning

confidence: 99%

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Penetrating nose and maxillary sinus injury with a metal part of a military gun

2016

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Foreign bodies (FBs) in the paranasal sinuses are rare, whether iatrogenic or traumatic. One of the most common causes of such traumatic injuries is gunshot wounds from the bullets. Removing FBs from the paranasal sinuses usually needs endoscopic or open surgery. We present the case of a 22-year-old male soldier who sustained a penetrating injury of his nose and maxillary sinus with an iron rod that was a part of his gun, which was removed without either endoscopic or open paranasal sinus surgery.

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Endoscopic Management of Transnasal Intracranial Penetrating Foreign Bodies

Perakis

Woodard

2010

The Laryngoscope

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ConclusionAs experience with endoscopic sinus surgery has grown, so have its extended applications. Endoscopic management of transnasal intracranial foreign bodies can be successfully performed in selected patients and yields an improved cosmetic outcome and a decreased risk in complications.The patient was a 21 year old male who was driving intoxicated and sustained a motor vehicle accident. Patient was ejected from his vehicle and launched toward a tree. Patient presented to our institution with a tree branch which had entered the left aspect of his oral cavity piercing through his gingival labial sulcus, traveling into his left nasal cavity, penetrating through the septum into the right nasal cavity, traveling intracranially and piercing white matter. There was no evidence of a CSF leak at time of presentation.CT Head was performed which showed the skull base defect produced by penetrating organic foreign body.Penetrating intracranial foreign bodies were removed using endoscopic sinus equipment. The resulting CSF leak was repaired at the same time.In the literature there are three other patients with transnasal intracranial penetrating foreign bodies managed endoscopically. Of these patients, one had an organic substance, whereas the other two patients had metallic foreign bodies. Endoscopic removal was successful in all patients and the CSF leak was repaired in all patients with a multi-layered closure following retrieval of the foreign body. One patient had a lumbar drain placed at time of retrieval whereas one patient had endoscopic removal with assistance of image guidance. None of the patients suffered complication including meningitis, CSF leak, brain abscess, hydrocephalus, neural/vascular injury or death, which are all associated with craniotomy.Intracranial foreign bodies generally require a craniotomy approach which is associated with a significant risk of perioperative morbidity. Whereas the transnasal endoscopic approach is a minimally invasive technique with lower associated morbidity/mortality. One may still need to manipulate surrounding brain parenchyma although there is no added potential risk, as there is with a craniotomy where the frontal lobe is retracted.Recommendations for endoscopic management of intracranial penetrating foreign bodies includes: use of Image guidance, neurosurgical consultation, and angiography to assess for intracranial vascular injury which should be considered a contraindication to the endoscopic approach, as vigorous bleeding would compromise endoscopic visualization.

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Endoscopic Transnasal Management of Intracranial Foreign Bodies

Cited by 27 publications

References 15 publications

Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Endoscopic Treatment of Transnasal Intracranial Penetrating Foreign Body

Penetrating nose and maxillary sinus injury with a metal part of a military gun

Endoscopic Management of Transnasal Intracranial Penetrating Foreign Bodies

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