Conservative management of transnasal intracranial injury

Bai, Weiliang; Shao, Chunbo; Sun, Wenyue; Ha, Patrick K.; Califano, Joseph A.; Cao, Zhiwei

doi:10.1016/j.amjoto.2009.11.005

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 32, Issue 2 , Pages 165-167, March 2011

Conservative management of transnasal intracranial injury

Weiliang Bai, PhD, MD
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, China
- Corresponding author. Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang 110004, China. Tel.: +86 24 83955152; fax: +86 24 83955092.
Chunbo Shao, PhD, MD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Wenyue Sun, PhD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
Patrick K. Ha, MD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Johns Hopkins Head and Neck Surgery at GBMC, Greater Baltimore Medical Center, Baltimore, MD, USA
Joseph A. Califano, MD
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA
- Johns Hopkins Head and Neck Surgery at GBMC, Greater Baltimore Medical Center, Baltimore, MD, USA
Zhiwei Cao, PhD, MD
- Department of Otorhinolaryngology, Shengjing Hospital, China Medical University, Shenyang, China

Received 11 October 2009 published online 08 January 2010.

Abstract

The purpose of this study was to explore the conservative management for an unusual case of transnasal intracranial injury. A 3-year-old female child presenting with transnasal injuries after a domestic accident whereby she apparently fell while holding a large pair of scissors, which then penetrated her left nasal cavity, piercing her nasal cavity, ethmoid sinus, and skull base. The scissors were removed from her nasal cavity. The patient had scant cerebrospinal rhinorrhea and no other additional neurologic deficits noted at the time, as well as no long-term developmental deficits. This report highlights the occurrence of this rare condition. The role of radiologic studies such as computed tomographic scans and plain films in diagnosis and management of this case is affirmed. The strategy of minimally invasive treatment of this injury can be a reasonable treatment option.