title: Endoscopic removal of a bullet penetrating the middle cranial fossa.
abstract: Reports of intracranial retained foreign bodies are relatively rare in the literature. Such objects can cause numerous complications requiring removal, such as infection, persistent cerebrospinal fluid (CSF) leak, or new-onset seizures. The transnasal endoscopic approach provides an excellent alternative to craniotomy for repairing middle cranial fossa (MCF) defects. We describe a case of a 57-year-old woman with a self-inflicted bullet piercing the MCF, creating a persistent CSF leak. The details regarding the removal of this penetrating foreign body from the MCF, including the unique management in the setting of a contralateral spontaneous CSF leak, are discussed.
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Birmingham, Alabama.
authors: Neal U
authors: NU
authors: Hatch
authors: Kristen O
authors: KO
authors: Riley
authors: Bradford A
authors: BA
authors: Woodworth
keywords: Middle cranial fossa; endoscopic approach; foreign body; skull base surgery
references: Otolaryngol Head Neck Surg. 2009 Jun;140(6):826-33
references: 19467398
references: Neurosurgery. 1992 Feb;30(2):291-4; discussion 294-5
references: 1545906
references: J Laryngol Otol. 2007 Aug;121(8):794-5
references: 17367560
references: Laryngoscope. 2006 Oct;116(10):1882-6
references: 17003708
references: Curr Opin Otolaryngol Head Neck Surg. 2009 Feb;17(1):59-65
references: 19225307
references: Otolaryngol Head Neck Surg. 2008 Jun;138(6):715-20
references: 18503841
references: AJNR Am J Neuroradiol. 1998 Jun-Jul;19(6):1163-5
references: 9672032
references: AJNR Am J Neuroradiol. 2005 Aug;26(7):1855-7
references: 16091543
references: Emerg Radiol. 2007 Apr;14(1):45-9
references: 17265026
references: Am J Rhinol Allergy. 2009 Mar-Apr;23(2):167-71
references: 19401043
references: Pediatr Neurol. 1987 Jan-Feb;3(1):44-7
references: 3334008
references: J Fam Pract. 1992 Apr;34(4):498-500, 502, 504
references: 1556543
references: Arch Otolaryngol Head Neck Surg. 2004 Aug;130(8):985-8
references: 15313871
references: Br J Neurosurg. 2000 Apr;14(2):159-60
references: 10889896
references: Head Neck. 2005 Jun;27(6):445-51
references: 15825205