背景:鼻外伤存在异物侵入鼻腔的风险。然而,在鼻外伤的早期治疗阶段,病人和医生并不总是意识到可能的异物入侵,导致检测延迟。我们描述了一名成年患者因左侧鼻塞伴有黄色而入院的情况,脓性的,和血腥的放电。
方法:对患者的咨询显示30年前有鼻外伤史,但在治疗期间没有接受彻底的检查和成像,导致玻璃碎片保留在邻近眼眶的鼻腔中。入院后,计算机断层扫描(CT)证实患者左鼻上颌窦存在异物。鼻异物导致慢性鼻窦炎等症状,鼻息肉,真菌感染,鼻中隔偏曲.通过鼻内镜成功取出异物,息肉切除术,鼻窦真菌切除,左中鼻甲成形术,经右下鼻道开窗,鼻内镜上颌窦膀胱切除术,还有中隔成形术.手术成功,无任何并发症。
结论:除了必要的清创缝合外,还应进行CT扫描,以避免鼻外伤期间可能的异物侵入。手术计划应根据患者的具体情况量身定制。手术方法应慎重选择,手术前应做好充分的准备,以避免鼻腔异物移位。
BACKGROUND: Nasal trauma presents a risk of foreign body invasion into the nasal cavity. However, in the early treatment stage of nasal trauma, patients and doctors are not always aware of possible foreign body invasion, resulting in delayed detection. We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow, purulent, and bloody discharge.
METHODS: Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment, resulting in a glass fragment retained in the nasal cavity adjacent to the orbit. After admission, computerized tomography (CT) confirmed the presence of the foreign body in the patient\'s left nasal-maxillary sinus. The nasal foreign body led to symptoms such as chronic sinusitis, nasal polyps, fungal infection, and deviated nasal septum. The foreign body was successfully removed by nasal endoscopy, polypectomy, sinus fungal removal, left middle turbinate conchoplasty, fenestration via the right inferior meatus, nasal endoscopic maxillary sinus cystectomy, and septolplasty. The operation was successful and without any complications.
CONCLUSIONS: CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma. Surgical planning should be tailored to the patient\'s specific situation. The surgical method should be carefully selected, and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.