Penetration of a Wooden Foreign Body into the Zygomaticomaxillary Bone to the Nasal Cavity: Navigation-Guided Successful Treatment

Abstract

Penetrations of the nasal cavity through the zygomaticomaxillary bone by wooden foreign bodies have not been reported yet. Wooden foreign bodies, characterized as hypodense signals resembling air bubbles on computed tomography scans, could increase the risk of infection and abscess formation if left untreated. Therefore, any possible attempts to remove it entirely should be made in a timely manner. Also, regarding removal surgery, the complications of the surgery, such as massive bleeding or iatrogenic injury to the adjacent structure, should be considered, especially in the paranasal area. At the construction site, a 67-year-old worker hit his right cheek with a wooden foreign body. A wooden foreign body penetrated the right cheek and extended into the right nasal cavity through the zygomaticomaxillary complex. Using a navigation system, the wooden foreign body was removed from the right zygomaticomaxillary bone to the unilateral nasal cavity, and we cauterized arterial bleeding. After bleeding control, we reconstructed the bony defect with an absorbable mesh with screws. Septal reconstruction was also done, along with debridement and irrigation of the nasal cavity. We conducted a follow-up computed tomography scan a week later and confirmed that the wooden foreign body was successfully removed without any residual ones. The fracture was also reduced successfully.