Endoscopic Management of a Chronic Ethmoid and Sphenoid Sinus Foreign Body

Abstract

ities in ciliary structure that impair mucociliary transport. 9 The finding of compound cilia alone in a patient does not in itself signify diminished mucociliary clearance. This finding requires evaluation with other tests such as technetium-99-labeled albumin scanning or possibly the cost-effective saccharin test. 1 Ciliary motion also can be evaluated with highspeed cinematography or a video system with slow-or stopmotion capabilities when viewing through a phase-contrast microscope. 2 The effects of compound cilia and other nonspecific axonemal defects on mucociliary clearance are not completely understood. 3 Our patient had slightly diminished mucociliary clearance, which can be attributed to her high numbers of compound cilia. These cilia are known to exist in mucosal disorders such as chronic rhinitis, sinusitis, and PCD, but it is unclear whether the abnormality is a cause or result of the disease. Conceivably the compound cilia are a result of mucosa undergoing rapid regeneration from various infectious conditions and conditions leading to ciliary destruction. Regardless, this abnormality may be seen in patients with chronic respiratory illnesses and, as in our case, in those with a mild immunodeficiency. More knowledge is needed concerning the influence of these ultrastructural abnormalities on the effectiveness of the mucociliary transport mechanism. REFERENCES1. Karga J, Nuutinen J, Karjalainen P. Radioisotopic method for measurement of nasal mucociliary activity. Arch Otolaryngol 1982;108(2):99-101. 2. Rossman CM, Newhouse MT. Primary ciliary dyskinesia: evaluation and management. Pediatr Pulmonol 1988;5:36-50. 3. Mygind N, Pedersen M, Nielson MH. Primary and secondary ciliary dyskinesia. Acta Otolaryngol (Stockh) 1983;95(5-6): 688-94. 4. Burgersdijk FJA, DeGroot JC, Graamans K, Rademakers LH. Testing ciliary activity in patients with chronic and recurrent infections of the upper airways: experiences in 68 cases. Laryngoscope 1986;96(9 pt 1):1029-33. 5. LeMauviel L. Primary ciliary dyskinesia. West J Med 1991; 155(9):280-3. 6. Smallman LA. Microtubular abnormalities of cilia in acquired pulmonary diseases. Lancet 1984;1(8383):965-6. 7. Afzelius BA, Camner P, Mossberg B. Acquired ciliary defects compared to those seen in immotile-cilia syndrome. Eur J Respir Dis 1983;64(Suppl 127):5-10. 8. Rossman CM, Lee RMKW, Forrest JB, et al. Nasal cilia in normal man, primary ciliary dyskinesia and other respiratory disease: analysis of motility and ultrastructure. Eur J Resp Dis 1983;64(Suppl 127):71-7. 9. Min YG, Kim IT, Park SH. Mucociliary activity and ultrastructural abnormalities of regenerated sinus mucosa in rabbits.Whereas foreign bodies of the nose are relatively common, foreign bodies of the paranasal sinuses occur infrequently. They may present in a delayed fashion, frequently with symptoms of chronic inflammation, and necessitate careful removal because of their relationship to vital structures. 1 We present a case of chronic sinusitis caused by a sphenoid and ethmoid sinus foreign body of 16 years'...

Penetrating nose and maxillary sinus injury with a metal part of a military gun

“…The classic open surgical technique is the Caldwell-Luc procedure9 and open surgical techniques are preferred in large FBs like our case. Alternatively, a transnasal endoscopic approach which has been successful in retrieval of smaller FBs in paranasal sinuses;10 however, the method of removal depends on size and location of the FB and the surgeon's preference. In some cases, especially in fragmented FBs, a combined approach of open surgery and endoscopic approach may be used to completely remove all fragmented parts 2.…”

Impacted Intra Sphenoid Foreign Body in an Adult: A Rare Event and a Lucky Survivor

“…8,11,15 However rarely open approaches are also needed for the purpose of removal of foreign bodies in the spheno-ethmoidal region. 10,16 In the present case the foreign body was found to be located in floor of the sphenoid sinus in the CT scan and hence an endoscopic approach was used for the removal of the foreign body and it could be safely removed without any procedure related complication or sequel.…”

Endoscopic Transnasal Management of Intracranial Foreign Bodies

“…[4][5][6] The low associated morbidity has led endoscopic approaches to supplant open approaches in the removal of sinonasal foreign bodies in most centers. However, depending on the nature and location of the foreign body, combined approaches may be necessary to allow removal of all fragments.…”