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Craniofacial penetration by a wooden stick

S Yoshihara1, S Baba1, A Kanemaru1

  • 1Department of Otorhinolaryngology - Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Otolaryngology, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-City, Tokyo 183-8561, Japan.

European Annals of Otorhinolaryngology, Head and Neck Diseases
|March 18, 2019
PubMed

Insights

Penetrating craniofacial injuries from stick-like objects in children can cause serious neurological damage. Prompt endoscopic removal is crucial, even with seemingly minor external wounds, to prevent severe complications.

Area of Science:

  • Pediatric Neurosurgery
  • Ophthalmology
  • Emergency Medicine

Background:

  • Penetrating craniofacial injuries, often from stick-like foreign bodies, pose a significant risk of morbidity, particularly in children.
  • Accidental injuries can lead to severe complications if not managed appropriately.

Observation:

  • A 5-year-old boy sustained a penetrating facial injury from a wooden stick entering through the left cheek.
  • The foreign body traversed the orbital cavity and anterior skull base, penetrating 3cm into the frontal lobe.
  • Initial neurological and vital signs were normal despite the deep intracranial penetration.

Findings:

  • Successful removal of the wooden stick was achieved using an endoscopic transethmoidal approach, visualizing the anterior skull base.
  • One-year follow-up revealed normal visual acuity and ocular motility, with no reported diplopia, tearing, or pain.

Implications:

  • Penetrating facial injuries, even those appearing trivial externally, carry a high risk of neurological involvement.
  • The cheek is an uncommon entry point for intracranial injuries, necessitating thorough assessment of the extent of damage.
  • Endoscopic techniques offer a viable approach for managing complex intracranial foreign body retrieval.
Abstract

Keywords:
CheekCraniofacial injuryEndoscopic transnasal approachForeign body

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