Transorbital Removal of Foreign Body in the Sphenoid Sinus

Abstract

Objective: To report a case of foreign body lodged within the sphenoid sinus and its extraction.
 
 Methods:
 Design: Case Report
 Setting: Tertiary Government Hospital
 Patient: One
 
 Results: An 11-year-old girl was hit in the eye by an unknown object from an improvised slingshot. She had loss of vision of the left eye and headache, without loss of consciousness. A plain craniofacial Computed Tomography (CT) scan showed a round opaque foreign body abutting the left sphenoid sinus, left posterior ethmoid cells and medial aspect of the left orbital region with adjacent soft tissue densities extending into the apparently ruptured, irregular left globe. The left posterior part of the lamina papyracea was not visualized, probably fractured or ruptured. Transorbital enucleation of the left eye and endoscopic-guided removal of the foreign body (a glass marble) were performed with no intra – operative and post – operative complications.
 Conclusion: Foreign body of the sphenoid sinus is a rare condition. Adequate imaging is important for localization and planning the optimal surgical approach. Endoscopic guidance may aid in extraction.
 Keywords: Sphenoid sinus foreign body, Computed Tomography (CT), Endoscopic-guided, transorbital approach

Endoscopic trans-nasal removal of impacted bullet in the sphenoid sinus: a case report

“…Thus, foreign body lodged in the sphenoid sinus is a rare condition. 4 The main and most important diagnostic procedure available is CT Scan of the head which can localize the foreign body as well as demonstrate bone fragments and other lesions. Coronal CT sections provide good views of the sphenoid and adjacent paranasal sinuses and possible intracranial penetration.…”

“…It also showed that the foreign body could be removed with endoscopic trans-nasal approach. 4 It is very common to see a foreign body in the nasal cavity or in the external ear canal but seeing it in likely places like the sphenoid sinus is such a surprise. Many factors need to be considered in the decision to extract it.…”

“…The occurrence of foreign body impaction in sphenoid sinus is extremely rare. [1][2][3][4][5] The maxillary sinus was affected in 75% cases and the frontal sinus is about 18%. Involvement of the ethmoid or sphenoid sinus is rare.…”

“…These may include wood, cotton, gauze, bullet, shrapnel, glass pieces, and bone wax. 4 Foreign bodies reach the sphenoid sinus either through the orbit or the nasal cavity. Proximity of the sphenoid sinus to vital structures such as the optic nerve and internal carotid artery may render life-threatening complications.…”

Sphenoid sinus foreign body following airbag deployment in the United States: a case report

“…Several traumatic cases of traumatic sinonasal foreign bodies have been reported. Most commonly, injuries involving high-velocity trauma, such as firearms [1][2][3], ballistic projectiles [4], and high falls [5,6], increase the risk of penetrating foreign bodies. However, even falls from standing height impart enough force to result in sinus penetration [7,8].…”