Endoscopic removal of foreign body from the anterior cranial fossa

Intracranial foreign bodies are typically removed via a craniotomy, which carries significant peri-operative risks. Nasal endoscopy for removal of intracranial foreign bodies is rare and has been attempted only a few times. Here, we describe a case in which nasal endoscopy was employed to successfully remove an air rifle pellet from the anterior cranial fossa, with subsequent repair of the associated cerebrospinal fistula. We thus advocate nasal endoscopy as an alternate line of management for the removal of foreign bodies from the anterior cranial fossa when possible, due to its significantly lower associated morbidity, provided adequate neurosurgical backup is available if required.