ARTICLE IN PRESS
YBJOM-4485; No. of Pages 1
Available online at www.sciencedirect.com
British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
Letter to the Editor An unusual foreign body in the nose? Sir, A middle-aged woman presented to the emergency department with evidence of superficial trauma to the skin of the forehead after a mechanical fall. Occipitomental radiographs showed what appeared to be a round, uniformly radiopaque foreign body against the medial wall of the maxilla in the right nasal cavity (Fig. 1). She was initially referred to
maxillofacial surgery and then to ENT for a consultation. Flexible nasoendoscopy, to our surprise, showed no visible foreign body. It was only on a detailed exploration into her past medical history that she revealed she had had endovascular coiling of a berry aneurysm many years earlier. On closer inspection the edges of the object did appear to have a linear coil-like quality, and we concluded that this was the object we could see on the radiograph. The case highlights the need for a detailed past medical history even in patients with minor injuries. More importantly, it reminded us of a radiology professor who continually said: never forget a radiograph is a 2-dimensional image of a 3-dimensional object. Sometimes we need to think outside the face.
Conflict of interest We have no conflicts of interest. K.F.B. Payne ∗ Core Surgical Trainee, West Midlands Deanery, United Kingdom R. Khandoker ENT SHO, Russells Hall Hospital, Dudley, United Kingdom A. Abdelrahim ENT Registrar, Russells Hall Hospital, Dudley, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (K.F.B. Payne)
Fig. 1. Occipitomental 0◦ plain radiograph with foreign body visible and appearing to lie in the right anterior nasal cavity.
http://dx.doi.org/10.1016/j.bjoms.2015.03.014 0266-4356/© 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Payne KFB, et al. An unusual foreign body in the nose? Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.03.014
YBJOM-4485; No. of Pages 1
Available online at www.sciencedirect.com
British Journal of Oral and Maxillofacial Surgery xxx (2015) xxx–xxx
Letter to the Editor An unusual foreign body in the nose? Sir, A middle-aged woman presented to the emergency department with evidence of superficial trauma to the skin of the forehead after a mechanical fall. Occipitomental radiographs showed what appeared to be a round, uniformly radiopaque foreign body against the medial wall of the maxilla in the right nasal cavity (Fig. 1). She was initially referred to
maxillofacial surgery and then to ENT for a consultation. Flexible nasoendoscopy, to our surprise, showed no visible foreign body. It was only on a detailed exploration into her past medical history that she revealed she had had endovascular coiling of a berry aneurysm many years earlier. On closer inspection the edges of the object did appear to have a linear coil-like quality, and we concluded that this was the object we could see on the radiograph. The case highlights the need for a detailed past medical history even in patients with minor injuries. More importantly, it reminded us of a radiology professor who continually said: never forget a radiograph is a 2-dimensional image of a 3-dimensional object. Sometimes we need to think outside the face.
Conflict of interest We have no conflicts of interest. K.F.B. Payne ∗ Core Surgical Trainee, West Midlands Deanery, United Kingdom R. Khandoker ENT SHO, Russells Hall Hospital, Dudley, United Kingdom A. Abdelrahim ENT Registrar, Russells Hall Hospital, Dudley, United Kingdom ∗ Corresponding author. E-mail address: [email protected] (K.F.B. Payne)
Fig. 1. Occipitomental 0◦ plain radiograph with foreign body visible and appearing to lie in the right anterior nasal cavity.
http://dx.doi.org/10.1016/j.bjoms.2015.03.014 0266-4356/© 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Payne KFB, et al. An unusual foreign body in the nose? Br J Oral Maxillofac Surg (2015), http://dx.doi.org/10.1016/j.bjoms.2015.03.014
