Sphenoid Sinus Foreign Body After Le Fort I Osteotomy

Area of Science:

• Otorhinolaryngology
• Neurosurgery
• Medical Device Technology

Background:

• Le Fort I osteotomy is a common maxillofacial surgical procedure.
• Complications, though rare, can occur during osteotomy, including instrument fracture.
• Foreign bodies in the sphenoid sinus are exceptionally uncommon.

Purpose of the Study:

• To report a rare case of a retained osteotome tip in the sphenoid sinus following Le Fort I osteotomy.
• To describe the diagnostic and management strategies for this unusual foreign body.
• To highlight the successful use of endoscopic techniques for removal.

Main Methods:

• Computed tomography (CT) was used to identify the foreign body's location and characteristics.
• Intraoperative instrument assessment confirmed the source of the foreign body.
• Interventional endoscopy combined with navigation CT was employed for foreign body retrieval.

Main Results:

• A 2-mm round foreign body, identified as the tip of a Bauer osteotome, was located in the right sphenoid sinus.
• The foreign body was successfully removed using endoscopic surgery.
• Post-operative assessment indicated a favorable prognosis.

Conclusions:

• Retained surgical instruments, such as osteotome tips, are rare but significant complications in Le Fort I osteotomy.
• Advanced imaging and endoscopic navigation are crucial for diagnosing and managing such foreign bodies.
• Minimally invasive endoscopic removal can achieve successful outcomes for sphenoid sinus foreign bodies.