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Long-term Retention of Ethmoid Sinus Foreign Body Manifested as Chronic Paranasal Sinusitis

以慢性鼻竇炎表現之長期篩竇異物

摘要


以慢性鼻竇炎表現之長期篩竇異物相當罕見,本部曾經歷一39歲男性英文老師,主訴近半年來有鼻音加重且合併化膿性鼻涕之情況,理學檢查發現兩側中鼻道呈現息肉樣病變並有化膿之鼻涕,電腦斷層顯示兩側篩竇及上頷竇明顯病變,經鼻竇內視鏡手術意外發現一個4 cm×0.8 cm之塑膠柱狀原子筆頭穿越鼻中隔橫跨在兩側篩竇問,患者鼻竇炎之情況在異物取出後及門診追蹤治療後大幅改善。回顧病史,病人曾於20年前被同學以原子筆由左顏面部刺入,當時在X光及理學檢查並無明顯體內異物,於是逕行取出筆桿並縫合左觀部傷口,而將原子筆頭遺留在篩竇至今,回顧開刀前之電腦斷層也只隱約找到一個切面有疑似異物,此報告提醒我們在處理顏面外傷患者時,要注意是否有異物存在,本文並對副鼻竇異物侵入之途逕作文獻回顧。

並列摘要


Sinusitis due to long-term retention of sinus foreign body is uncommon. We report a 39 year-old man who had suffered from bilateral ethmoid sinusitis for 20 years. A ballpoint pen cap was found incidentally during functional endoscopic sinus surgery. Sinus symptoms were relieved dramatically after foreign body removal. Compared with other sinus disorders, ethmoid sinus foreign body is an unusual condition. We review the literature associated with sinus foreign bodies and discuss their routes of penetration and complications.

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