Shah Hassan Yousaf, Elshaer Rawan Emad, Arabi Tarek Ziad, Sabbah Belal Nedal, Alokby Ghassan
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2022 Jul;96:107280. doi: 10.1016/j.ijscr.2022.107280. Epub 2022 Jun 6.
Foreign bodies in paranasal sinuses are rarely encountered and most commonly present in the maxillary sinus. Guidelines for managing paranasal sinus object removal are limited due to its rarity. However, there are three major management options: open surgery, endoscopic sinus surgery, and observation.
We report a rare case of an 18-year-old boy who underwent extended frontal sinus surgery to retrieve a retained air gun pellet in the right frontal sinus and repair the skull base defect resulting from the air gun pellet.
Physicians commonly use endoscopic sinus surgery (ESS) for improving sinus drainage in recurrent chronic and acute infective sinusitis. Extended sinus surgery aims to maximize the communication between the paranasal sinuses and the nasal cavity. This extended communication helps improve access to the sinus, enhance drainage, and improve the delivery of topical medications. In addition, the use of ESS with the modified Lothrop procedure allows for better exposure of the skull base, which can help with the repair of a CSF leak.
Based on our experience with this patient and similar literature, ESS should be considered a treatment option for patients with retained foreign objects in the frontal sinus.
鼻窦异物很少见，最常出现在上颌窦。由于鼻窦异物的罕见性，关于处理鼻窦异物取出的指南有限。然而，主要有三种处理方法：开放手术、鼻内镜鼻窦手术和观察。
我们报告一例罕见病例，一名18岁男孩接受了扩大的额窦手术，以取出右额窦内残留的气枪子弹，并修复气枪子弹造成的颅底缺损。
医生通常使用鼻内镜鼻窦手术（ESS）来改善复发性慢性和急性感染性鼻窦炎的鼻窦引流。扩大鼻窦手术旨在最大限度地增加鼻窦与鼻腔之间的连通。这种扩大的连通有助于改善鼻窦的通路、增强引流并改善局部药物的输送。此外，采用改良Lothrop手术的ESS能够更好地暴露颅底，这有助于修复脑脊液漏。
基于我们对该患者的经验以及类似文献，对于额窦内有异物残留的患者，应考虑将ESS作为一种治疗选择。
