phenylephrine-hydrochloride and Foreign-Body-Migration

Transnasal penetration by a nonmissile foreign body is a rare injury. Consequently, appropriate management remains controversial. We report a case of transnasal penetration by a ballpoint pen and review the literature. To our knowledge, this is the first living patient who sustained carotid artery damage from a transnasal penetrating intracranial injury.. A 56-year-old female presented with a ballpoint pen lodged through her left nostril. She exhibited right cranial nerve palsies (III, IV, VI, and V1). A computed tomography (CT) scan of the head revealed a foreign body in the left nasal cavity traversing the ethmoid/sphenoid and likely through the right superior orbital fissure and cavernous sinus, with the distal tip adjacent to the right atrium. CT angiography revealed nonopacification of the right internal carotid artery (ICA) from the mid-petrous segment to the ophthalmic segment. Subsequently, she underwent coil embolization of the proximal right ICA, followed by a right frontotemporal craniotomy with anterior temporal lobectomy to skeletonize the pen and right distal ICA, and finally clipping of the ICA distal to the pen and prompt transnasal endoscopic removal of the pen. There were no hemorrhagic complications. She awoke at her neurologic preoperative baseline.. Injuries such as the one described here should be managed through a multidisciplinary approach. The trajectory of the foreign body should be delineated through CT imaging, along with vascular imaging if appropriate. If there are signs of vascular injury, then attempts to maintain proximal and distal control are prudent to avoid hemorrhagic complications. This combined endovascular-endoscopic-open craniotomy approach has not been reported previously in the literature.

Topics: Angiography, Digital Subtraction; Carotid Artery, Internal; Craniotomy; Embolization, Therapeutic; Endoscopy; Female; Foreign-Body Migration; Humans; Interdisciplinary Communication; Intersectoral Collaboration; Middle Aged; Nose; Self-Injurious Behavior; Temporal Lobe; Tomography, X-Ray Computed; Wounds, Stab

Displacement of dental implants into the maxillary sinus is a rare complication. This article presents a case of displaced dental implant into maxillary sinus. Retrieval of the dental implant from left maxillary sinus was performed via endoscopic sinus surgery. This case highlighted a delayed referral of a 53-year-old male by a general dental practitioner for management of a dislodged dental implant into the left maxillary antrum. The implant was dislodged during placement of a healing abutment 4 months after implant insertion to replace missing 25. Cone beam computerized tomography revealed the displaced implant was located at the ostium of the left nose. A sudden change in sinonasal pressure when the patient took a deep breath during the procedure may have created a negative pressure and suction effect causing the implant to be dislodged and embedded at the ostium. In view of its position, a referral to an otorhinolaryngologist was made for endoscopic removal of the displaced implant. This case also highlighted the need for inter disciplinary cooperation in the management of such a complication for the best interest of the patients.

Topics: Cone-Beam Computed Tomography; Dental Implants; Endoscopy; Foreign-Body Migration; Humans; Male; Maxillary Sinus; Middle Aged; Nose

The Australian population is 10% of Asian origin, and many of our Asian patients have had nasal augmentation using prosthetic material prior to immigration or as medical tourists back in their country of origin. Insertion of nasal prostheses is the most common way to augment the nasal dorsum in the Asian patient and although there is a trend towards autogenous primary augmentation still, the vast majority of patients seen in clinical practice have had augmentation by the insertion of foreign material generally silicone. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Topics: Adult; Asian People; Autografts; Biocompatible Materials; Device Removal; Female; Foreign-Body Migration; Humans; Male; Middle Aged; Nose; Plastic Surgery Procedures; Prostheses and Implants; Prosthesis Failure; Prosthesis Implantation; Prosthesis-Related Infections; Rhinoplasty; Silicones; Transplantation, Autologous; Young Adult

Topics: Airway Obstruction; Female; Foreign-Body Migration; Humans; Intraoperative Complications; Intubation, Intratracheal; Nose; Prostheses and Implants; Prosthesis Failure; Silicones; Young Adult

Abstract Nasal foreign bodies may result from the abundant availability of tiny objects in our society and a curious child exploring his or her nasal cavities. An inserted object that is not witnessed or retrieved can remain relatively asymptomatic or cause local tissue damage and potentially yield more serious consequences. An unusual case of a young child who presented for dental rehabilitation under general anesthesia is described. Immediately prior to the nasotracheal intubation, an unanticipated foreign body was detected and safely removed before any injury occurred. This case report discusses the presentation and pathophysiology of nasal foreign bodies. Moreover, applicable suggestions are provided to aid in the prevention and management of the unexpected discovery of a nasal foreign body after the induction of general anesthesia.

Topics: Anesthesia, General; Child, Preschool; Epistaxis; Foreign Bodies; Foreign-Body Migration; Humans; Intubation, Intratracheal; Male; Nose; Suction

Foreign body aspiration is a commonly encountered emergency in children. Foreign body can lodge in any site from supra-glottis to the terminal bronchioles. Symptoms might range from none to respiratory compromise, cardiac arrest and even death depending on location and size. We report successful management of a child who aspirated a nasal foreign body during physical examination in an outpatient department causing complete airway obstruction with special mention about different management options available for managing near total respiratory arrest from an aspirated foreign body in the ED.

Topics: Airway Obstruction; Child, Preschool; Female; Foreign Bodies; Foreign-Body Migration; Humans; Nose; Respiratory Aspiration

Endoscopic surgery via nasal approach to remove the implant body from the semilunar hiatus is presented with the images of the computed tomography and the intraoperative endoscopic findings.

Topics: Dental Implants; Endoscopes; Endoscopy; Female; Foreign-Body Migration; Humans; Maxillary Sinus; Maxillary Sinusitis; Middle Aged; Nose; Tomography, X-Ray Computed

Topics: Adult; Asthma; Body Piercing; Diagnosis, Differential; Female; Follow-Up Studies; Foreign-Body Migration; Humans; Intestine, Small; Nose; Radiography, Abdominal; Radiography, Thoracic

Topics: Aged; Bandages; Female; Foreign-Body Migration; Humans; Nose; Nose Diseases; Oral Fistula; Palate, Hard; Polyps

We report a case of migration of a dental implant into the maxillary sinus and discuss the benefits of endoscopic transnasal removal of such implants. As the sole approach, this technique has rarely been described. The most commonly used technique for retrieval of dental implants is the Caldwell-Luc procedure. This, however, has certain morbidity associated with it and may compromise subsequent implant insertion.

Topics: Dental Implants; Endoscopy; Female; Foreign-Body Migration; Humans; Maxillary Sinus; Middle Aged; Nose; Oral Surgical Procedures

Rigid fixation has been used over the past 20 years for the long-lasting correction of traumatic and congenital craniofacial defects. It has been noted that the use of plates and screws can result in the migration of the hardware through the skull to the inner cerebral cortex where it embeds in the dura. In addition, there is controversy concerning the safety of using titanium plates in the pediatric population. We report here on an 8-year-old boy who presented to our clinic with a chronic headache after rigid craniofacial fixation using titanium plates 7 years before.

Topics: Bone Plates; Bone Screws; Child; Chronic Disease; Craniosynostoses; Craniotomy; Dura Mater; Foreign Bodies; Foreign-Body Migration; Headache; Humans; Male; Nose

Augmentation rhinoplasty using soft tissue and cartilage was performed on 120 patients and the results were reexamined. They were found to be satisfactory and without complication. To narrow a round tip, a resection of two-thirds of the lateral crus cephalad portion and a transection of the caudal portion with a strip resection was done. To elevate the tip, septal cartilage was sutured to one-third of the upper part of medial crus to form a columella cartilage strut. To maintain the strut and to prevent pointing, a fibrous muscle tissue stretching from the medial crus to the upper cartilage or a dermis was transplanted into the area surrounding the septal cartilage tip. For a simple elevation of the dorsum, an onlay graft of dermis was applied, but where further elevation was required, further dermis and conchal cartilage was added for suture and attachment to the dermis.

Topics: Adult; Cartilage; Evaluation Studies as Topic; Female; Follow-Up Studies; Foreign-Body Migration; Humans; Middle Aged; Nasal Septum; Nose; Prostheses and Implants; Rhinoplasty; Silicones; Surgical Flaps; Suture Techniques