A rare case of a penetrating cranio-facial foreign body stuck in the skull base

INTRODUCTION: Penetrating craniofacial wounds due to foreign bodies, specifically sharp white blades, represent an eventual life threatening condition and a rare case of emergency facial surgery requiring a complex medical care. We report an original case of a penetrating craniofacial wound by a knife with a review of the literature concerning the tendencies, the complications and the specific medical care needed for these particular cranio-facial lesions. PRESENTATION OF CASE: A 35 year old man admitted to our ENT emergency room with a penetrating craniofacial wound caused by a knife stuck in the cranio-orbital-nasal junction. A craniofacial profile x-ray showed the presence of the metallic foreign body, a knife, penetrating deeply to the base of the skull. Computed tomography showed that the transcranial metallic foreign body arrived in the right sellar region after passing through the nasal cavity and the right sphenoid sinus with hemosinus and suprentorial pneumocephaly. the management consisted of multidisciplinary management, and the extraction was performed successfully under 3D endoscopic control. CONCLUSION: The majority of penetrating craniofacial wounds secondary to foreign bodies, regardless of their size, are rarely associated with major neurological symptoms and their management must be adapted to their potential severity.