An unusual craniofacial injury. A case report.

A 13-year-old White boy was operated on for a penetrating craniofacial injury caused by a speargun fishing harpoon. The missile penetrated the left nasal ala, traversed the maxillary sinus and the postero-medial wall of the latter and penetrated the posterior nasopharyngeal soft tissue and mucous membrane, almost abutting the anterior surface of the atlas. At an emergency procedure the missile was retrieved via a combined lateral rhinotomy/Caldwell-Luc approach. In spite of the horrific appearance of the accident there was no neurological deficit and vascular findings were minimal.