Isolated sphenoid sinus foreign body following slingshot injury: a case report

BACKGROUND: Impaction of foreign bodies within the paranasal sinuses secondary to slingshot projectiles is uncommon, with only three documented case reports within the literature. There are no clear guidelines for the management of these injuries, and given the heterogeneity of their presentations, various methods of foreign body extraction have been employed, ranging from enucleation of the affected eye to transnasal endoscopic approaches. CASE PRESENTATION: This case report describes the presentation and successful management of a 36-year-old male with a ruptured left globe and no perception of light (NPL) visual acuity secondary to a slingshot projectile. CT imaging of the head and orbits revealed a 17 mm-diameter metallic foreign body impacted solely within the sphenoid sinus. A review of the literature confirmed this to be the first reported case of an isolated sphenoid sinus foreign body secondary to a slingshot projectile mechanism. CONCLUSIONS: This report highlights the necessity of a multidisciplinary approach in managing complex sino-orbital foreign body injuries. It underscores the ophthalmic rationale and benefits of primary repair of a globe perforation in the setting of NPL vision, as well as the novel endoscopic techniques employed to achieve minimally invasive foreign body retrieval.