Retrieval of projectile foreign bodies from the paranasal sinuses and skull base

Abstract

Although not all retained foreign bodies after penetrating trauma to the head require removal, those that are safely accessible and at risk for infectious complications should be recovered. The timing and approach of retrieval are dictated by the clinical scenario.

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun

“…1,2 Management of penetrating trauma to the paranasal sinuses and skull base with retained foreign bodies represents a challenge due to the proximity to vital neurovascular structures. 3,4 Preoperative CT scan is the preferred modality to show bony landmarks and vascular structures; however, although both CT scan and magnetic resonance imaging are increasingly being used, in the case of nail gun injuries significant artefacts secondary to the nail probably preclude these studies. 5 Blind removal of foreign bodies has been reported, 6 however the development of combined-multiportal endoscopic approaches enabled surgeons to reach different regions through minimally invasive routes with lower incidence of complications, lower morbidity, and mortality rates compared with traditional external approaches.…”

Guns n’ Noses: Endoscopic Removal of an Air-Gun Pellet Retained in the Frontal Sinus

“…Approximately 2% of penetrating head and neck traumas result in retained FBs in the sinuses or skull base. 1 Air-gun injuries to the sinuses represent a small proportion of head and neck penetrating trauma. 1 Approximately 60% of air-gun pellets are retained in the tissue that is first struck as they do not contain enough kinetic energy to penetrate through soft tissue and bone.…”

Case report: retained gutta-percha as a cause for persistent maxillary sinusitis and pain

“…There are multiple case reports in the otolaryngology literature of projectiles that have become lodged in the paranasal sinuses 1 . Retained packing gauze from endoscopic sinus surgery has also been reported in the paranasal sinuses 2 .…”