Craniocerebral injury resulting from pencil penetration

Penetrating craniofacial trauma in pediatric age group is quite rare. A case is reported that presented with a pencil penetration injury entering from the anterior maxillary sinus through the orbital medial wall, and ethmoidal cells and septum, reaching the contralateral gyrus rectus of the frontal lobe. All the vital structures were preserved. The patient was first treated with manual extraction of the pencil, without any immediate complications; however, rhinorrhea followed the procedure 4 h later. Early endoscopic surgical intervention was performed and the rhinorrhea was successfully treated in this case. This report discusses radiological and surgical characteristics of this unusual penetrating craniofacial trauma.