Chronic foreign body of the nasal cavity and sphenoid sinus: surgical implications

Chronic sinonasal foreign bodies present unique surgical challenges including tissue integration and anatomic migration. A patient with a history of multiple surgeries for cleft lip, palate, and nasal deformity presented with radiographic findings of a 4.3-cm linear foreign body traversing the nasal cavity and sphenoid sinus. Mucosalization and integration into the sphenoid rostrum were noted at the time of surgery. Endoscopic surgery techniques facilitated removal of the overlying mucosa and encasing bone, allowing successful surgical extraction. On inspection, the foreign body was consistent with a retained Kirschner wire. Potential pathophysiologic and management implications of this case are discussed.