Foreign body of the nose, ethmoid sinuses and orbit penetrating to middle cranial fossa
Journal Title: Polski Przegląd Otorynolaryngologiczny - Year 2013, Vol 2, Issue 1
Abstract
We present the case of wooden foreig n body penetrating the nasal cavity, ethmoid sinus, orbit and brain, comp licated by the right eye blindness . 29-year-old man was admitted because of the foreign body pen etrating by the bridge of the nose. Exophthalmos, lack of mobility and reaction to ligh t and loss of vision of the right eye were found. The CT show ed the foreig n body pen etrating through the open left nasal bone fr acture to the nasal cavity, by the nasa l septu m and ethmoid sinus into the right orbit and the mi ddle crani al fossa, modeling the right internal caro tid artery. The foreign body was remove d under general anesthesia. The CT show ed no intracranial bleeding. The lac erated wound and the fracture of the nose were trea ted, bilateral ante rior pack was inserted. The arteriograp hy revealed partial right caver nous sin us thrombo sis. In the MR I after a month of treatment cavernous sinus was normally contrasted. In the neuro -ophthalmological examination the right CN II, III, IV, VI and V1 damag e were found. The patients was qualifi ed to sept oplasty because of the deviation of the nasal septum and nasal synechiae. Foreign bodies of facial skeleton are associated with da nger of severe complications and permanent disability and require close coope ration of the laryngologist, neurosu rgeon, radiologist and ophtha lmologist.
Authors and Affiliations
Maciej Kawczyński, Elżbieta Włodarczyk, Paweł Kawalec, Beata Paradowska-Opałka, Krzysztof Rzewuski
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