CLINICAL VIDEO

TITLE: Endoscopic sinus surgery for foreign body extraction in an adult patient

Cardella A^1,2, Preti A^1,3, Gera R¹, Ottaviani F^1,2, Mozzanica F^1,2

1 Department of Otorhinolaryngology, Ospedale San Giuseppe IRCCS Multimedica, Milan, Italy

2 Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

3 Department of Medicine and Surgery, University of Insubria, Varese, Italy

Corresponding author

Cardella Arianna, MD

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

Via San Vittore 12, Milan, Italy

Email: arianna.cardella@unimi.it

Telephone: +39 0285994471

ABSTRACT

The management of an unusual nasal foreign body is illustrated. A 34-year-old male presented to our outpatient clinic after inhalation of liquid cast during preparation of a plaster mask. The foreign body had solidified within the nasal cavities, causing obstruction and headache. Ambulatory removal was incomplete, therefore ESS was indicated.

KEY CLINICAL MESSAGE

Foreign bodies are an unusual indication for endoscopic sinus surgery. Whenever their extraction is not possible in the outpatient setting and acute sinusitis ensues, thorough exploration and extended dissection under general anesthesia should be taken into consideration in order to clear the nasal cavities.

KEYWORDS

Nasal foreign body – ESS - endoscopic sinus surgery

TEXT

Nasal foreign bodies are extremely common in the pediatric population while being an infrequent presentation for adults [1]. They are a predisposing factor for acute bacterial rhinosinusitis [2] and management of such infection cannot overlook the complete removal of the foreign body.

We illustrate the case of a 34-year-old male who developed nasal obstruction, headache and purulent rhinorrhea following the inhalation of liquid cast during preparation of a plaster mask. Complete ambulatory removal of the solidified cast was not possible, prompting a thorough dissection through endoscopic sinus surgery in order to clear all debris and explore the paranasal cavities.