Imagine having a 4-inch nail in your face without realizing it. This is what happened to a 32-year-old man who fell while climbing a coconut tree. After the fall, he noticed facial wounds but didn’t seek immediate medical attention due to the distance from the nearest hospital.
Encouraged by his concerned relatives, he eventually visited the emergency room. There, an X-ray of his face revealed a shocking finding: a long nail embedded in his right maxillary sinus. Fortunately, the nail was angled to the side, avoiding potentially more dangerous structures behind the nose and above the eye.
At the Emergency Room
Upon arrival at the emergency room, the medical team swiftly assessed the patient. The immediate priorities were to manage the patient’s pain and run diagnostic tests to assess the facial injury, as well as start medications to prevent infection.
X-rays confirmed the presence of the nail, prompting the team to coordinate with an ENT surgeon and ophthalmologist. The patient was prepared for surgery, with steps taken to stabilize his condition and plan the removal of the foreign object.
ENT Surgical Intervention
In the operating room, the ENT surgeon, the ophthalmologist and surgical team faced the delicate task of removing the nail from the man’s maxilla. The procedure began with debriding and cleaning the wounds to reduce infection risk.
The surgeons carefully extracted the nail, mindful of the surrounding critical structures, especially the eye. After the successful removal, Dr Estimar sutured the wounds and ensured no further damage had occurred. Post-operative care included administration of anti-tetanus medication and antibiotics to prevent infection.
Potential Complications and Risks Associated with Maxillofacial Injuries
Facial injuries come with significant risks, including infection, nerve damage, potential facial deformities, bleeding and complications related to the sinuses. The ENT doctor and medical team closely monitored the patient for signs of infection and other potential complications. Regular follow-ups were scheduled to ensure proper healing and to address any issues promptly, minimizing long-term risks associated with the injury.
The Patient’s Recovery and Rehabilitation
Following surgery, the patient began his recovery journey. He spent three days in the hospital, receiving care to manage pain and prevent infection. Instructions for at-home care included dietary restrictions to avoid straining the surgical site and activity limitations to promote healing. With comprehensive care, the patient was able to return home, for full recovery.
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