Chronic Maxillary Sinusitis Secondary to a Retained Wooden Foreign Body: A Case Report

Area of Science:

• Otolaryngology
• Medical Imaging
• Surgical Navigation

Background:

• Retained wooden foreign bodies in the maxillary sinus present diagnostic and therapeutic challenges due to low radiodensity.
• Mimicry of fungal infections on imaging complicates diagnosis, especially with prolonged latency.
• This case highlights the utility of advanced surgical navigation in managing such complex cases.

Purpose of the Study:

• To present a case of a long-latency wooden foreign body in the maxillary sinus initially misdiagnosed as fungal sinusitis.
• To demonstrate the effectiveness of electromagnetic navigation-guided endoscopic sinus surgery (ENG-ESS) in managing complex foreign body removal.
• To propose a framework for diagnosing and treating similar refractory cases.

Main Methods:

• A 31-year-old male with recurrent infraorbital abscesses and facial swelling, misdiagnosed with fungal sinusitis.
• Initial treatments including abscess drainage and endoscopic sinus fenestration were unsuccessful.
• Electromagnetic navigation-guided endoscopic sinus surgery (ENG-ESS) was employed to locate and remove a 5-year retained wooden fragment.

Main Results:

• The patient presented with symptoms mimicking chronic sinusitis and abscesses.
• A 4.5 cm wooden fragment, retained for 5 years, was identified in the maxillary sinus.
• ENG-ESS successfully localized and removed the residual fragment, leading to complete resolution of infection and symptoms.

Conclusions:

• Wooden foreign bodies in the maxillary sinus can be misdiagnosed, emphasizing the need for thorough trauma history and advanced imaging.
• ENG-ESS offers superior precision for navigating complex sinus anatomy and minimizing complications from residual foreign bodies.
• A trauma history-guided dynamic imaging-navigation surgery framework is proposed for managing long-latency, refractory cases.