1
|
Ozmarasali AI, Kaplan AD, Eser P, Yilmazlar S. Dental implant misplacement into the anterior cranial fossae: a unique case and review of literature. Neurochirurgie 2024; 70:101533. [PMID: 38246017 DOI: 10.1016/j.neuchi.2024.101533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 12/29/2023] [Indexed: 01/23/2024]
Affiliation(s)
| | - Aylin Dogan Kaplan
- Department of Oral Implantology, Oral Implantology PhD Program, Istanbul University, Health Sciences Institute, 34126, Istanbul, Turkey
| | - Pinar Eser
- Department of Neurosurgery, Medical School, Bursa Uludag University, 16059, Bursa, Turkey
| | - Selcuk Yilmazlar
- Department of Neurosurgery, Medical School, Bursa Uludag University, 16059, Bursa, Turkey.
| |
Collapse
|
2
|
Hoey A, Troy C, Bauerle W, Xia A, Hoey B. Delayed-Onset Seizures Following Self-Inflicted Nail Gun Injury to the Head: A Case Report and Literature Review. J Neurol Surg Rep 2022; 83:e54-e62. [PMID: 35756905 PMCID: PMC9232295 DOI: 10.1055/s-0042-1749650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/29/2022] [Indexed: 11/23/2022] Open
Abstract
Nail gun use and its associated incidence of injury have continued to increase since it was first introduced in 1959. While most of these injuries involve the extremities, a subset of patients suffer intracranial trauma. The most recent comprehensive review on this particular subject referenced 41 cases and advocated for further discussion regarding proper treatment plans for these individuals. We present the case of a 25-year-old who suffered 35 self-inflicted penetrating head wounds from a nail gun after suffering an amputation injury at his job site. No neurological deficits were present on his arrival to the emergency room. He underwent surgery to treat his arm wound and remove 13 of the 35 nails. The patient was discharged from the hospital on levetiracetam and made a full recovery. Nearly 1 year later, he experienced a seizure at his workplace. However, after resuming his antiepileptic medication, he reports no further complications. This case is distinct for not only being the most nails in a patient's head at presentation, but also following surgery. Utilizing this case, prior review, and 27 subsequent cases, we propose an updated algorithm for diagnosis and treatment of nail-gun-related penetrating head trauma.
Collapse
Affiliation(s)
- Alexander Hoey
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, United States
| | - Christopher Troy
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Wayne Bauerle
- Department of Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Anthony Xia
- Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Brian Hoey
- Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| |
Collapse
|
3
|
Duddleston PJ, Gendreau JL, Little KA, Andrews A, Thompson WD. Navigation-guided neuroendoscopic removal of an intracranial migratory pellet from the thalamus of a 4-year-old girl. J Neurosurg Pediatr 2020; 26:445-448. [PMID: 32650311 DOI: 10.3171/2020.4.peds19606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 04/20/2020] [Indexed: 11/06/2022]
Abstract
Extraction of a bullet fragment seated in deep brain parenchyma utilizing a neuroendoscope has not been previously reported in the literature. The authors report the case of a 4-year-old patient who presented after a pellet gun injury with a projectile located 6 cm intracranially and lodged within the posterior thalamus and near the posterior limb of the internal capsule. Initial operative repair included repair of a CSF leak with duraplasty, minimal brain debridement, and elevation of a depressed skull fracture. Subsequent CT at 2 months postoperatively revealed migration of the deep intracranial pellet. This finding correlated with intermittent worsening neurological symptoms and signs. A rigid 3-mm neuroendoscope with CT stereotactic navigation was then used to remove the pellet fragment from the thalamus. The patient returned home with alleviation of clinical symptoms and an uneventful postoperative recovery. This case demonstrates that navigation-guided neuroendoscopy can be successfully used to remove projectile fragments from deep brain structures, especially when the migration is along the initial path of the bullet. This technique represents another low-risk curative option in the management of retained bullet fragments in gunshot wound injuries to the head.
Collapse
Affiliation(s)
| | | | | | - Amber Andrews
- 2Neurological and Spine Institute of Savannah, Georgia
| | | |
Collapse
|
4
|
Ghadersohi S, Ference EH, Detwiller K, Kern RC. Presentation, workup, and management of penetrating transorbital and transnasal injuries: A case report and systematic review. Am J Rhinol Allergy 2018; 31:29-34. [PMID: 28452700 DOI: 10.2500/ajra.2017.31.4421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A foreign body (FB) penetrating intracranially after passing transorbitally or transnasally is a rare occurrence. However, otolaryngologists are increasingly being asked to participate in the care of these patients for both endoscopic removal of the object and repair of any skull base defects. OBJECTIVE To assess the presentation, workup, and management of transnasal or transorbital penetrating FB injury. METHODS Systematic review of the presentation, workup, and management of transnasal or transorbital penetrating FB injury; plus, a case report of a 53-year-old woman with a transorbital penetrating rose bush branch. We searched medical literature data bases, which resulted in 215 total titles, which were then narrowed based on inclusion and exclusion criteria. RESULTS Thirty-five cases of transorbital or transnasal low-velocity trauma that involved the paranasal sinuses were reviewed from 33 articles. The average age was 30 years, 40% of the objects were made of wood. Fifty-seven percent of the cases were transorbital, whereas 43% were transnasal. Forty-six percent of the surgical interventions were completed endoscopically or with endoscopic assistance. Complications of injury were common, with 66% of patients experiencing cerebrospinal fluid leaks; 23%, permanent blindness; 17%, meningitis; 14%, ophthalmoplegia; 9%, decreased visual acuity; and 3%, brain abscess. Our patient presented with a traumatic cerebrospinal fluid leak, and recovered well after transorbital and endoscopic removal of the branch, skull base repair, and a prolonged course of antibiotics and antifungal medications. CONCLUSIONS Transnasal and transorbital penetrating FB injuries are a relatively uncommon occurrence but when they do occur require rapid workup and interdisciplinary management to prevent acute and delayed complications.
Collapse
Affiliation(s)
- Saied Ghadersohi
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | | | | |
Collapse
|
5
|
Sinonasal metallic foreign body penetration of the anterior cranial fossa. OTOLARYNGOLOGY CASE REPORTS 2017. [DOI: 10.1016/j.xocr.2017.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
6
|
Li XS, Yan J, Liu C, Luo Y, Liao XS, Yu L, Xiao SW. Nonmissile Penetrating Head Injuries: Surgical Management and Review of the Literature. World Neurosurg 2016; 98:873.e9-873.e25. [PMID: 27931948 DOI: 10.1016/j.wneu.2016.11.125] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/24/2016] [Accepted: 11/25/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Nonmissile penetrating head injuries (NPHIs) in the civilian population are rare but potentially fatal. Although numerous cases have been reported in the literature, the surgical management of such injuries is still ambiguous, especially with development of surgical techniques. Here, we report 5 cases of NPHIs managed with different surgical techniques and review the literature on surgical treatment of these injuries to outline the appropriate management for these patients from a neurosurgical perspective. METHODS We retrospectively reviewed 5 cases of NPHIs managed surgically in our department. The clinical data were collected, including cause, type of objects, way of penetration, initial clinical evaluation, imaging, surgical intervention, postoperative care, complication, follow-up, and outcome. In addition, a systematic review of the literature was performed in the PubMed database to search for articles on surgical treatment of these injuries. RESULTS These 5 cases were caused by twisted steel bar, electric welding rod, and sewing needle, respectively. Preoperative imaging, including computed tomography, magnetic resonance imaging, and digital subtraction angiography, was selectively performed to assist the operative plan. Foreign objects were removed surgically in all cases. Postoperative prophylactic administration of antibiotics and anticonvulsants was used to prevent infectious and epileptic complications. Most of the patients achieved a better outcome except for one. CONCLUSIONS NPHIs can be fatal but they can be managed with satisfactory results by proper preoperative imaging evaluation, rapid appropriate surgical management, and accurate postoperative care. Personalized surgical intervention should be undertaken depending on the mechanism and extent of the NPHI.
Collapse
Affiliation(s)
- Xi-Sheng Li
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Jun Yan
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chang Liu
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yu Luo
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Xing-Sheng Liao
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Liang Yu
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Shao-Wen Xiao
- Department of Neurosurgery, The First Affiliated hospital of Guangxi Medical University, Nanning, Guangxi, China.
| |
Collapse
|
7
|
Cho J, Kim JH, Hong SD. Complex Anterior Skullbase Fracture Caused by a Bottle Cap: A Case Report and Review of the Literature. JOURNAL OF RHINOLOGY 2016. [DOI: 10.18787/jr.2016.23.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jungkyu Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Ho Kim
- Department of Rhinology, Hana ENT Hospital, Seoul, Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
8
|
Wieland AM, Curry WT, Durand ML, Holbrook EH. Management of a long-standing organic intracranial foreign body. Skull Base 2011; 20:487-90. [PMID: 21772810 DOI: 10.1055/s-0030-1261264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Organic foreign bodies of the skull base are an uncommon problem with the potential for serious morbidity that present complicated treatment dilemmas best managed by a multidisciplinary approach. A 58-year-old male presented to the emergency department with fevers and mental status changes and was found to have bacterial meningitis. Computed tomography of the sinuses revealed two adjacent defects of the ethmoid roof with associated soft tissue density concerning for an encephalocele. He had a remote history of a penetrating left maxilla injury with a stick 13 years earlier. An attempted endoscopic repair of the defects revealed a pulsating splinter of wood emanating from the ethmoid roof defect. Neurosurgery and infectious disease were consulted and several wood fragments were removed endoscopically from the intracranial space. The skull base defects were closed using a septal cartilage underlay and free mucosal overlay graft. The patient has done well in follow-up with no evidence of cerebrospinal fluid leak. Organic foreign bodies from skull base trauma can have a delayed presentation and require a multidisciplinary team approach. In the appropriate setting endoscopic removal is a minimally morbid option.
Collapse
|
9
|
Kamat A, Tabaee A. Chronic foreign body of the nasal cavity and sphenoid sinus: surgical implications. Cleft Palate Craniofac J 2011; 49:114-7. [PMID: 21534843 DOI: 10.1597/10-253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Ameet Kamat
- New York Eye and Ear Infirmary, Department of Otolaryngology–Head and Neck Surgery, New York, New York, USA
| | | |
Collapse
|
10
|
Hatch NU, Riley KO, Woodworth BA. Endoscopic removal of a bullet penetrating the middle cranial fossa. SKULL BASE REPORTS 2011; 1:47-50. [PMID: 23984202 PMCID: PMC3743583 DOI: 10.1055/s-0031-1275633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 01/24/2011] [Indexed: 11/04/2022]
Abstract
Reports of intracranial retained foreign bodies are relatively rare in the literature. Such objects can cause numerous complications requiring removal, such as infection, persistent cerebrospinal fluid (CSF) leak, or new-onset seizures. The transnasal endoscopic approach provides an excellent alternative to craniotomy for repairing middle cranial fossa (MCF) defects. We describe a case of a 57-year-old woman with a self-inflicted bullet piercing the MCF, creating a persistent CSF leak. The details regarding the removal of this penetrating foreign body from the MCF, including the unique management in the setting of a contralateral spontaneous CSF leak, are discussed.
Collapse
Affiliation(s)
- Neal U Hatch
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Birmingham, Alabama
| | | | | |
Collapse
|
11
|
Pousti SB, Izadi F, Nikpour N, Shirali A. How Plastic and Endoscopic Assisted Surgery Can Help Foreign Body Removal? Indian J Otolaryngol Head Neck Surg 2011; 72:513-514. [PMID: 33088784 DOI: 10.1007/s12070-011-0177-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 08/08/2008] [Indexed: 11/29/2022] Open
Abstract
In this study we report a case with foreign body in the infratemporal fossa. The anatomic position of this region and the presence of important neurovascular structures make this region a sophisticated one. Commonly used open procedures can have morbidity of neurovascular system. To prevent probable complications like facial nerve injury in this case which was the most important factor for us, we decided to remove the foreign body under endoscopic guide.
Collapse
Affiliation(s)
- Seyed Behzad Pousti
- E.N.T Department & Ear, Nose, Throat, and Head & Neck Surgery Research Center, Hazrat Rasoul - Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzad Izadi
- E.N.T Department & Ear, Nose, Throat, and Head & Neck Surgery Research Center, Hazrat Rasoul - Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Nikpour
- E.N.T Department & Ear, Nose, Throat, and Head & Neck Surgery Research Center, Hazrat Rasoul - Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Shirali
- E.N.T Department & Ear, Nose, Throat, and Head & Neck Surgery Research Center, Hazrat Rasoul - Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
12
|
Cho YC, Jang SM, Park SW, Choi BH, Ha JH, Son JH, Sung IY. Removal of foreign body on cheek using endoscope and C-arm fluoroscopy. J Korean Assoc Oral Maxillofac Surg 2011. [DOI: 10.5125/jkaoms.2011.37.3.234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Yeong-Cheol Cho
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soo-Mi Jang
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soo-Won Park
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Byung-Hwan Choi
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jin-Hee Ha
- Department of Conservative Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jang-Ho Son
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Iel-Yong Sung
- Department of Oral & Maxillofacial Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| |
Collapse
|