PMC7580137_01
Coronal computed tomography images show multiple straight-air lines running from the base of the maxillary sinus to the roof of the ethmoid sinuses of both nasal cavities ((a) non-enhanced image and (b) enhanced image).
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Paranasal sinus computed tomography (CT) revealed multiple straight hairlines spanning the base of the bilateral maxillary sinuses and anterior ethmoidal sinus (Figure 1).
(a) Intraoperative nasal endoscopy view. Multiple wooden toothpicks were seen in the middle meatus of both nasal cavities (white triangle). (b) Eight toothpicks were removed from the right side and 27 from the left side. All foreign bodies were removed by the endoscopic endonasal route.
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After uncinectomy and middle meatal antrostomy, multiple foreign bodies that penetrated through the maxillary sinus walls over the ethmoid sinus were found on both sides (Figure 2). Eight foreign bodies on the right side and 29 on the left side were removed through the nasal cavity (Figure 2), and ethmoidectomy and sphenoidotomy were performed to conclude the surgery.
Preoperative oroantral fistula ((a) left and (b) right) (white arrow). (c) The left oroantral fistula was closed with a buccal flap. (d) The right oroantral fistula was closed with a palatal flap.
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Four foreign bodies on the right side and 11 on the left side were removed through endoscopic sinus surgery under general anesthesia, and oroantral fistula closure was performed using the buccal flap for the left fistula and the palatal flap for the right fistula (Figure 3).