Craniofacial ballpoint pen injury: Endoscopic management

Penetrating facial injuries are not infrequent. There have been isolated ca se reports of unusual penetrating craniofacial trauma. We describe an unusu al case of a 22-month-old child who suffered an external orbital injury fro m a ballpoint pen that penetrated the orbit, lamina papyracea, posterior et hmoid sinuses, and sphenoid sinus. Endoscopic sinus surgery was performed t o extract the ballpoint pen nib after localization with computed tomography . Careful pediatric endoscopic sinus surgery techniques permitted safe fore ign body extraction with minimal morbidity.