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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

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Foreign body within sphenoid sinus: multidetector-row computed tomography (MDCT) demonstration.

Nisar Ahmad Wani¹, Abdul Qayum Khan

¹Sher-i-Kashmir Institute of Medical Sciences, Department of Radiology, Srinagar, J&K, India. nisar.wani@yahoo.com

Turkish Neurosurgery

|October 22, 2010

Summary

A rare case of a gun bullet lodged in the sphenoid sinus, penetrating the sella turcica, was reported. Uniquely, the bullet was spontaneously coughed out by the patient.

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Area of Science:

Otolaryngology
Neurosurgery
Radiology

Background:

Trans-nasal foreign bodies in the sphenoid sinus are uncommon.
Penetration into the sella turcica presents unique diagnostic and management challenges.

Observation:

A 42-year-old soldier presented with headaches weeks after a gun battle.
Imaging revealed a gun bullet within the sphenoid sinus, breaching the sella turcica floor.

Findings:

Multidetector-row CT confirmed the bullet's intra-sphenoid and intra-sellar location.
The patient spontaneously expectorated the bullet without surgical intervention.

Implications:

This case highlights the possibility of spontaneous foreign body expulsion from the sphenoid sinus.
It underscores the importance of advanced imaging in diagnosing rare craniofacial trauma.
Such unique presentations expand our understanding of foreign body migration and resolution.