Foreign Body in Paranasal Sinus: A Late Clinical Presentation

Area of Science:

• Otolaryngology
• Medical Imaging
• Surgical Pathology

Background:

• Foreign bodies within the paranasal sinuses are exceptionally uncommon.
• Symptoms are often nonspecific, leading to delayed diagnosis, frequently after intracranial or extracranial complications arise.
• A high index of clinical suspicion is crucial for early detection.

Observation:

• A 64-year-old female patient presented with headache and purulent rhinorrhea.
• She had a history of paranasal sinus microsurgery over 30 years prior.
• A tubular glass foreign body was identified within the ethmoid complex.

Findings:

• The patient underwent successful functional endoscopic sinus surgery for removal of the glass foreign body.
• Glass, being inert, typically elicits minimal foreign body reaction.
• Obstruction of the ostiomeatal complex drainage by the foreign body likely led to secondary rhinosinusitis.

Implications:

• This case highlights the potential for long-term, asymptomatic foreign bodies in the paranasal sinuses.
• It underscores the importance of considering iatrogenic causes for chronic or recurrent rhinosinusitis, even decades after initial surgery.
• This is likely the first documented instance of a glass foreign body removed from the ethmoidal sinuses with such a prolonged duration of presence.