Existence of Paranasal Sinus Foreign Body for More Than 20 Years

Foreign bodies in paranasal sinuses are not unusual; however, it is unusual for a foreign body in the sinuses to evolve over a period of more than 20 years before the onset of symptoms related to the pharynx rather than to the nose. We present a case of a 43-year-old man who experienced nasal trauma more than 20 years ago. He presented with symptoms such as repeated sore throat and pharyngeal foreign body feeling accompanied by cough and sputum for more than a month. A long, hard, dark brown structure, identified as a special woody material (acerbity wood), was found obliquely lodged in the left ethmoid-maxillary sinus. Because dried acerbity wood may be an inert material that does not cause obvious foreign body reaction, the patient may not present any symptom for a long time. However, once sinusitis occurs, a backward flow of nasal mucus can cause pharyngitis, which we believe happened in the case of the patient discussed here. The patient underwent functional endoscopic sinus surgery, and the pharyngeal discomfort gradually disappeared after the surgery. To the best of our knowledge, this may be the first reported case of a special woody material that was removed from the ethmoid-maxillary sinused after more than 20 years of insertion, which was initially misdiagnosed as chronic pharyngitis.