Endoscopic-assisted Removal of an Impaled Rebar through the Face: a Case Report

Document Type : Case Report

Authors

Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

Abstract

Introduction: When a foreign body (FB) traverses or penetrates a body cavity or extremity is called impalement injury. Impalement injuries to the craniofacial region are rare. Surgical approaches should be chosen according to the patterns, mechanisms, materials of the injury, and adjacent vital structures. Current case report aimed to introduce endoscopic- assisted approach as a novel technique in removing penetrating foreign body of the orbit and paranasal sinuses.
Case Presentation: A thirty-year-old man was brought to the emergency department with a rebar penetrated into his left side of his face just superior to his orbital rim, through the orbit, adjacent to medial canthus. Computed tomography scan showed a metallic rod extending from area near medial canthus up to pterygoid plates. Patient underwent endoscopic assisted surgery under general anesthesia. After releasing of the rebar endoscopically, it was pulled out from the proximal portion.
Conclusion: Endoscopic-assisted surgery is a useful and novel approach in removing impacted FBs in PNS, particularly the FBs adjacent to arterial or venous plexus, dura, and the orbit.

Keywords

References

  1. Daya NP, Liversage HL. Penetrating stab wound injuries to the face. SADJ: journal of the South African Dental Association= tydskrif van die Suid-Afrikaanse Tandheelkundige Vereniging. 2004 Mar;59(2):55-9.
  2. Chrcanovic BR, de Souza LN, Freire-Maia B. Migration of tip knife blade through middle-third facial tissues. Oral and maxillofacial surgery. 2009 Mar 1;13(1):41.
  3. Meer M, Siddiqi A, Morkel JA, van Rensburg PJ, Zafar S. Knife inflicted penetrating injuries of the maxillofacial region: a descriptive, record-based study. Injury. 2010 Jan 1;41(1):77-81.
  4. S. Harvinder, L. Jenny, and S. Gurdeep, “An arrow in the maxillary sinus,” Medical Journal of Malaysia, vol. 63, no. 4, pp. 333-334, 2008.
  5. M. A. Mathews, B. A. Nair, S. Tandon et al., “Penetrating foreign body in the maxillary sinus and pterygopalatine fossa: report of a rare case,” The Internet Journal of Head and Neck Surgery, vol. 4, 2010.
  6. R. Sharma, R. Minhas, and N. Mohindroo, “An unusual foreign body in the paranasal sinuses,” Indian Journal of Otolaryngology and Head & Neck Surgery, vol. 60, no. 1, pp. 88–90, 2008. 
  7. Franceschetto L, Carlini L, Lancia M, Bacci M. An Unusual Case of Homicide by Impalement With a Battering Ram. The American journal of forensic medicine and pathology. 2019 Jun 1;40(2):150-2.
  8. Eppley BL. Craniofacial impalement injury: a rake in the face. Journal of Craniofacial Surgery. 2002 Jan 1;13(1):35-7.
  9. Akhiwu BI, Adoga AS, Binitie OP, Ani CC, Iweagwu M, Adetutu O, Ureme T, George DD, Didamson PD, Oseni-Momodu E, Ugwu BT. Impalement head injury with a spear. Journal of the West African College of Surgeons. 2016 Apr;6(2):113.
  10. H. R. Krause, J. Rustemeyer, and R. R. Grunert, “Foreign body in paranasal sinuses,” Mund-, Kiefer- und Gesichtschirurgie, vol. 6, no. 1, pp. 40–44, 2002. 
  11. D. Lee, M. Nash, J. Turk, and G. Har-El, “Low-velocity gunshot wounds to the paranasal sinuses,” Otolaryngology—Head and Neck Surgery, vol. 116, no. 3, pp. 372–378, 1997. 
  12. S. H. Batista, E. S. Soares, F. W. Costa et al., “Foreign body in the maxillary sinus. Considerations on maxillary sinus approaches wound closure.” Revue De Stomatologie Et De Chirurgie Maxillo-Faciale, vol. 112, pp. 316–318, 2011. 
  13. D. Macan, T. Ćabov, P. Kobler, and Ž. Bumber, “Inflammatory reaction to foreign body (amalgam) in the maxillary sinus misdiagnosed as an ethmoid tumor,” Dentomaxillofacial Radiology, vol. 35, no. 4, pp. 303–306, 2006. 
  14. K. M. Dodson, M. A. Bridges, and E. R. Reiter, “Endoscopic transnasal management of intracranial foreign bodies,” JAMA Otolaryngology–Head & Neck Surgery, vol. 130, no. 8, pp. 985–988, 2004. 
  15. J. Yousefi, A. Mobasher Jannat, and R. Ajudani, “Penetrating nose and maxillary sinus injury with a metal part of a military gun,” Journal of the Royal Army Medical Corps, vol. 162, no. 2, pp. 137-138, 2016. 
  16. Dominguete PR, Matos BF, Meyer TN, Oliveira LR. Jael syndrome: removal of a knife blade impacted in the maxillofacial region under local anaesthesia. BMJ case reports. 2013 Apr 10;2013:bcr-2013.
  17. C. Offiah and E. Hall, “Imaging assessment of penetrating injury of the neck and face,” Insights into Imaging, vol. 3, no. 5, pp. 419–431, 2012. 
  18. S. Sundereswaran, J. James, and S. Praveen, “Unusual foreign body in routine lateral cephalogram,” Journal of Clinical and Diagnostic Research, vol. 9, no. 2, pp. ZD10–ZD11, 2015. 
  19. Shenoy V, Maller V, Maller V. Maxillary antrolith: a rare cause of the recurrent sinusitis. Case reports in otolaryngology. 2013;2013.
  20. F. Pagella, E. Emanuelli, and P. Castelnuovo, “Endoscopic extraction of a metal foreign body from the maxillary sinus,” The Laryngoscope, vol. 109, no. 2, pp. 339–342, 1999. 
  21. M. Akgüner, A. Atabey, and H. Top, “A case of self-inflicted intraorbital injury: Wooden foreign body introduced into the ethmoidal sinus,” Annals of Plastic Surgery, vol. 41, no. 4, pp. 422–424, 1998. 
  22. P. Y. Chen, S. F. Yao, A. X. Dai, H. J. Chen, and K. W. Wang, “A shocking craniofacial penetrating injury by a steel bar,” Ulusal Travma ve Acil Cerrahi Dergisi, vol. 20, no. 5, pp. 382–384, 2014.
  23. N. Bhattacharyya and R. K. Wenokur, “Endoscopic Management of a Chronic Ethmoid and Sphenoid Sinus Foreign Body,” Otolaryngology—Head and Neck Surgery, vol. 118, no. 5, pp. 687–690, 2016.
  24. S. Kazim, A.-U. Bhatti, and S. Godil, “Craniocerebral injury by penetration of a T-shaped metallic spanner: A rare presentation,” Surgical Neurology International, vol. 4, no. 1, Article ID 106115, 2013.
Canon Journal of Medicine
Volume 4, Issue 3
September 2023
Pages 71-73

Files

History

  • Receive Date: 10 August 2019
  • Revise Date: 30 August 2019
  • Accept Date: 11 September 2019

Share

How to cite

Statistics