Endoscopic management of transnasal intracranial penetrating foreign bodies.

As experience with endoscopic sinus surgery has grown, so have its extended applications. Endoscopic management of transnasal intracranial foreign bodies can be successfully performed in selected patients and yields an improved cosmetic outcome and a decreased risk in complications. The patient was a 21 year old male who was driving intoxicated and sustained a motor vehicle accident. Patient was ejected from his vehicle and launched toward a tree. Patient presented to our institution with a tree branch which had entered the left aspect of his oral cavity piercing through his gingival labial sulcus, traveling into his left nasal cavity, penetrating through the septum into the right nasal cavity, traveling intracranially and piercing white matter. There was no evidence of a CSF leak at time of presentation.