Chronic maxillary sinusitis caused by a foreign body

Case contributed by Nerses Nersesyan
Diagnosis certain

Presentation

Symptoms of chronic sinusitis.

Patient Data

Age: 40 years
Gender: Male

Left maxillary sinus opacification and sclerotic, thickened maxillary and ipsilateral sphenoid sinus walls, associated with presence of hyperdense linear foreign body extending from the roof of the sphenoid sinus. Discontinuity in bony wall of maxillary sinus floor suggests possible point of penetration. Second, smaller fragment lodged in the thickened roof of the sphenoid bone.

A pencil lead almost 6 cm long was extracted during the surgical procedure. 

Case Discussion

The case is a rare example of chronic sinusitis caused by an unusual foreign body. The patient could not remember when the object was inserted and had not had any memory of the event whatsoever. However, he had a history of motor vehicle accident six years before the CT was performed.

The patient underwent surgery extracting a 6 cm pencil lead from his left maxillary sinus. 

The case is submitted in collaboration with Delfina Dualde Beltrán. 

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