Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
J Craniofac Surg. 2023 Jun 1;34(4):e403-e404. doi: 10.1097/SCS.0000000000009338. Epub 2023 Apr 17.
Penetrations of the nasal cavity through the zygomaticomaxillary bone by wooden foreign bodies have not been reported yet. Wooden foreign bodies, characterized as hypodense signals resembling air bubbles on computed tomography scans, could increase the risk of infection and abscess formation if left untreated. Therefore, any possible attempts to remove it entirely should be made in a timely manner. Also, regarding removal surgery, the complications of the surgery, such as massive bleeding or iatrogenic injury to the adjacent structure, should be considered, especially in the paranasal area. At the construction site, a 67-year-old worker hit his right cheek with a wooden foreign body. A wooden foreign body penetrated the right cheek and extended into the right nasal cavity through the zygomaticomaxillary complex. Using a navigation system, the wooden foreign body was removed from the right zygomaticomaxillary bone to the unilateral nasal cavity, and we cauterized arterial bleeding. After bleeding control, we reconstructed the bony defect with an absorbable mesh with screws. Septal reconstruction was also done, along with debridement and irrigation of the nasal cavity. We conducted a follow-up computed tomography scan a week later and confirmed that the wooden foreign body was successfully removed without any residual ones. The fracture was also reduced successfully.
目前尚未有木质异物穿透颧骨上颌骨进入鼻腔的报道。如果未进行治疗,木质异物在 CT 扫描上呈现出类似气泡的低信号特征,会增加感染和脓肿形成的风险。因此,如果有可能,应及时尝试将其完全取出。另外,对于取出手术,应考虑手术的并发症,如大出血或对邻近结构的医源性损伤,特别是在鼻旁区域。在工地上,一位 67 岁的工人被一根木质异物击中右脸颊。一根木质异物穿透右脸颊,穿过颧骨上颌复合体进入右侧鼻腔。使用导航系统,我们将木质异物从右侧颧骨上颌骨中取出,进入单侧鼻腔,并对动脉出血进行了烧灼。控制出血后,我们用可吸收网片和螺钉重建了骨缺损。还进行了鼻中隔重建、清创和鼻腔冲洗。一周后我们进行了 CT 随访扫描,确认成功地取出了所有的木质异物,没有残留。骨折也成功复位。