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Preoperative computed tomography scan. (a) Axial view; (b) Sagittal view. The metallic foreign body extends from the most lateral part of the posterior wall of the maxillary sinus to the pterygopalatine fossa, close to the pterygomaxillary fissure, and the greater wing of the sphenoid bone
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A maxillofacial computed tomography (CT) scan pointed out the presence of a highly hyperdense linear signal (consistent with a metallic FB) passing across the lateral portion of the posterior wall of the right MS, protruding into the lateral part of PPF and sticking into the greater wing of SB [Figure 1].
Three-dimensional skull model showing the area of drilling on the lateral wall of the right nasal cavity (yellow) for endoscopic prelacrimal approach
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Then, drilling of the lateral bony wall between the Hasner's valve and the pyriform aperture [Figure 2] through a diamond drill leads to entry into the MS and identification of the FB (a 1-cm long pin fragment).
Endoscopic view of the right anterior nasal cavity at 6-month follow-up. IT = inferior turbinate; MT = middle turbinate
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The endoscopic examination was regular, and the nasal cavity anatomy was intact, as shown in Figure 3.