Neuralgia-like symptoms in a patient with an airgun pellet in the ethmoid sinus: a case report

Abstract

An unusual case of a retained airgun pellet in the ethmoid sinus is presented. The patient's only complaint was a severe neuralgic headache. Anatomical basis for this symptom, imaging and successful endoscopic removal of the foreign body are discussed. The philosophy for removal of innocuous foreign bodies, potential pitfalls in surgical management, and a review of the literature are included in the discussion.

Endoscopic-Assisted Navigation-Guided Removal of Long-standing Metallic Foreign Body Near to the Sphenoid

“…In 2 cases, the retained metallic foreign was associated with malignancy. 2,[4][5][6] The foreign body should be removed as soon as possible, because removal at a later stage could be more difficult because of the foreign body's adhesions to the nearby structure and also its encapsulation by the fibrous tissue. 3,7 The decision to remove the foreign body should balance the risks of removal and the potential benefits, because damages to the vital structure are possible when approaching the foreign body.…”

Transorbital penetrating injury of the paranasal sinuses

“…This provided the advantages of low peri-operative morbidity, avoidance of a facial scar, and minimal invasiveness. However, should difficulty be encountered in defining landmarks due to bleeding or from distorted anatomy, the surgeon must be prepared to employ the more conventional external approaches (Donald et al, 1995). If we had pulled the pen directly from the protruding part instead of performing surgery, the pen might have been removed successfully.…”

“…They are most often seen in adults and are usually traumatic in origin (Grevers and Reiterer, 1990). Various foreign bodies, including glass (Onerci et al, 1997) metal fragments (Dimitriou et al, 1992), wood splinters (Fallon etai, 1992), bullets and pellets (Donald and Gadre, 1995), have been reported as' having been lodged in the paranasal sinuses. Here we present a rare case of transorbital penetrating injuries of the paranasal sinuses caused by a ballpoint pen.…”

Orbitoethmoid Metallic Foreign Body

“…It is usually traumatic and rarely iatrogenic. 1 Foreign body may be organic or inorganic. Retained organic foreign bodies can cause severe inflammation and are detected earlier, whereas inorganic foreign bodies are inert and well tolerated except copper.…”