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Craniocerebral injury resulting from pencil penetration


Penetrating craniofacial trauma in pediatric age group is quite rare. A case is reported that presented with a pencil penetration injury entering from the anterior maxillary sinus through the orbital medial wall, and ethmoidal cells and septum, reaching the contralateral gyrus rectus of the frontal lobe. All the vital structures were preserved. The patient was first treated with manual extraction of the pencil, without any immediate complications; however, rhinorrhea followed the procedure 4 h later. Early endoscopic surgical intervention was performed and the rhinorrhea was successfully treated in this case. This report discusses radiological and surgical characteristics of this unusual penetrating craniofacial trauma.

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  1. Gasparini G, Brunelli A, Rivaroli A et al (2002) Maxillofacial traumas. J Craniofac Surg 13:645–649

    Article  PubMed  Google Scholar 

  2. Masters SJ, McClean PM, Arcarese JS, Brown RF, Campbell JA, Freed HA, Hess GH, Hoff JT, Kobrine A, Koziol DF et al (1987) Skull x-ray examinations after head trauma. Recommendations by a multidisciplinary panel and validation study. N Engl J Med 316(2):84–91

    Article  CAS  PubMed  Google Scholar 

  3. Zinreich SJ, Miller NR, Aguayo JB et al (1986) Computed tomographic three-dimensional localization and compositional evaluation of intraocular and orbital foreign bodies. Arch Ophthalmol 104:1477–1482

    CAS  PubMed  Google Scholar 

  4. Fuller DG, Hutton WL (1990) Prediction of postoperative vision in eyes with severe trauma. Retina 10(Suppl 1):S20–S34

    PubMed  Google Scholar 

  5. Chu A, Levine MR (1989) Gunshot wounds of the eye and orbit. Ophthalmic Surg 20:729–736

    CAS  PubMed  Google Scholar 

  6. Wesley RE, Anderson SR, Weiss MR et al (1987) Management of orbital-cranial trauma. Adv Ophthalmic Plast Reconstr Surg 7:3–26

    CAS  PubMed  Google Scholar 

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Conflict of interest statement

The authors have no proprietary interest in any material or method described in this study.

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Correspondence to Serdar Ozer.

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Ozer, S., Onal, B., Akbay, A. et al. Craniocerebral injury resulting from pencil penetration. Eur Arch Otorhinolaryngol 267, 155–157 (2010).

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  • Rhinorrhea
  • Penetrating head injury
  • Cerebrospinal fluid leakage
  • Craniocerebral injuries