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长期眶周鼻异物存留致鼻阻塞:1例报告

Nasal congestion caused by long-term retention of a nasal foreign body near the orbit: A case report.

作者信息

Wang Dan, Liu Qing, Liu Hui, Wei Jia-Sha

机构信息

Department of Rhinology, Zibo Central Hospital, Zibo 255000, Shandong Province, China.

出版信息

World J Clin Cases. 2024 Jul 16;12(20):4331-4336. doi: 10.12998/wjcc.v12.i20.4331.

Abstract

BACKGROUND

Nasal trauma presents a risk of foreign body invasion into the nasal cavity. However, in the early treatment stage of nasal trauma, patients and doctors are not always aware of possible foreign body invasion, resulting in delayed detection. We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow, purulent, and bloody discharge.

CASE SUMMARY

Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment, resulting in a glass fragment retained in the nasal cavity adjacent to the orbit. After admission, computerized tomography (CT) confirmed the presence of the foreign body in the patient's left nasal-maxillary sinus. The nasal foreign body led to symptoms such as chronic sinusitis, nasal polyps, fungal infection, and deviated nasal septum. The foreign body was successfully removed by nasal endoscopy, polypectomy, sinus fungal removal, left middle turbinate conchoplasty, fenestration the right inferior meatus, nasal endoscopic maxillary sinus cystectomy, and septolplasty. The operation was successful and without any complications.

CONCLUSION

CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma. Surgical planning should be tailored to the patient's specific situation. The surgical method should be carefully selected, and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.

摘要

背景

鼻外伤存在异物侵入鼻腔的风险。然而,在鼻外伤的早期治疗阶段,患者和医生并不总是意识到可能存在异物侵入,导致检测延迟。我们描述了一名成年患者因左侧鼻塞伴黄色、脓性和血性分泌物入院的病例。

病例摘要

与患者会诊发现,患者30年前有鼻外伤史,治疗期间未接受全面检查和影像学检查,导致一块玻璃碎片留在鼻腔靠近眼眶处。入院后,计算机断层扫描(CT)证实患者左鼻上颌窦存在异物。鼻异物导致慢性鼻窦炎、鼻息肉、真菌感染和鼻中隔偏曲等症状。通过鼻内镜检查、息肉切除术、鼻窦真菌清除术、左侧中鼻甲成形术、右侧下鼻道开窗术、鼻内镜下上颌窦囊肿切除术和鼻中隔成形术成功取出异物。手术成功,无任何并发症。

结论

除必要的清创缝合外,应进行CT扫描,以避免鼻外伤期间可能的异物侵入。手术计划应根据患者的具体情况制定。应仔细选择手术方法,术前应做好充分准备,以避免鼻异物可能移位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aeb/11235564/641b20091f73/WJCC-12-4331-g001.jpg

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