Retrieval of an impacted foreign body from the frontal sinus and orbit via endoscope-assisted open surgery

Abstract

The occurrence of a foreign body in the frontal sinus is rare and generally results from high-velocity trauma. Here, we report the case of a 32-year-old male patient who had a large piece of wood impacted in his frontal sinus and left orbit after falling in a forest. Computed tomography imaging showed that a foreign body, approximately 9 cm in length, had shattered the anterior wall of the frontal sinus, entered the left orbit and fragmented the superior rim of the left orbit and that bone fragments were inserted in front of the foreign body. The posterior wall of the frontal sinus was intact and there was no cranial or skull base defect. Aside from a restriction in upward gaze, the ophthalmological examination revealed normal findings, while the patient reported diplopia in the left eye. The foreign body and all bony fragments were removed via endoscope-assisted open surgery, and the sinus wall was reconstructed with titanium mesh. The patient’s double vision improved immediately after surgery.