A 34 year old Bangalore patient, Mr X had an accidental air gun injury in which the bullet directly went through the eye and into the nose and sinuses. Multiple metal pellets got lodged between the eye and the paranasal sinuses. An eye specialist treated him said that he had initial vision problems which occurred due to the trauma. Some pellets remained in the junction where the optic nerve crosses near the nasal sinus, and posed a possible risk in the future.
Recently, the patient visited Dr. Shantanu Tandon, Consultant - Ear, Nose & Throat (ENT) at Sakra World Hospital for a thorough examination.
An endoscopic removal of these multiple pieces of the bullet was planned by Dr. Tandon. The challenge was that, these pellets were small, and surrounded by blood and tissue, and thus difficult to identify .The pieces had spread to different areas & were also very close to the eye. Dr Tandon used a surgical navigation system to assist the endoscopic surgery.
With the help of this excellent navigation technique, the doctors could get a sense of where the bullet pieces were lodged and how far they were from delicate nerves, eye and the brain . This aided in retrieving the pieces without any significant blood loss, shorter surgery time and patient recuperated in 2 ½ days.
What makes this surgery beneficial for patients: Endoscopic sinus surgery is the most popular method for treating “Sininasal Diseases”. However, there are some pitfalls with this technique that can result in serious complications. Under the assistance of a navigation system, surgeons can overcome such problems.
Air gun Injury through the eye into the nose and sinus
