Transnasal intracranial injury caused by the penetration of a vegetative foreign body through the nose: diagnosis and treatment

Abstract

Unintentional penetrating intracranial transnasal injuries are a real rarity. This case report describes one such injury that occurred when an adult male accidentally fell on a reed stalk during a walk. In addition to its bizarre occurrence, this injury is further interesting due to the absence of an open facial wound and a hidden intranasal foreign body which is a unique case. Intracranial injury was diagnosed by CT imaging of the head, and a foreign body identified by endoscopic examination of the nasal cavity. Foreign body removal surgery was performed with combined external transethmoid and endoscopic transnasal approach. Defect of bone structure, right cribriform plate and meninges was reconstructed with pedicular nasoseptal flap. The recovery of the casualty after surgery was complete and there were neither intracranial nor extracranial complications.