Endoscopic transnasal management of intracranial foreign bodies

Foreign bodies may be introduced into the paranasal sinuses or cranium through a variety of traumatic or iatrogenic events. A variety of open and, more recently, endoscopic approaches have been used for the removal of sinonasal foreign bodies. Intracranial foreign bodies, however, typically require retrieval via a craniotomy approach, which continues to carry significant perioperative risks. We describe the first reported case of an intracranial foreign body removed using the transnasal endoscopic approach with intraoperative image guidance. We discuss the preoperative evaluation required for this approach to be applied safely and successfully in properly selected cases.