A non-powder weapon projectile uneventfully removed from the pterygopalatine fossa: A case report

The cases of a ballistic projectile entering the pterygopalatine fossa are rare (8 reported cases), and the procedure of removing a foreign body from this anatomical space requires an operator’s experience and appropriate attention. We report the second case of a bullet from a non-powder weapon in the pterygopalatine fossa described in the English literature and the first removed by open trans-sinusal surgery. A 53-year-old male patient was shot and referred from another hospital for removal of a bullet from the pterygopalatine fossa. The patient had a craniofacial CT scan and was in good general condition. The foreign body was trans-sinusally non-endoscopically removed. The experience, knowledge and manual dexterity of the operator allowed avoiding iatrogenic complications such as intraoperative bleeding and nerve injury. The basis for a successful operation was good diagnostic, including radiological diagnostic consisting of performing a cranio-facial CT scan.