Foreign Body Retention of a Biro Pen from a Stab Facial Injury: A Two Year Experience

Background: Within the maxillofacial region, foreign bodies have been found in different areas like the maxillary antrum, parotid gland, orbit, cheek and floor of the mouth. Several factors like difficult access, the inflammatory response of the surrounding tissues, the size of the object and a close anatomy to vital structures can pose a diagnostic and treatment challenge to the maxillofacial surgeon. To this effect, good imaging technique is essential in locating the precise location of the objects in order to remove them promptly.

Objective: This article presents a case of stab injury on the face of a 25-year-male with a biro pen and its consequent retention for two years within the facial tissues before removal. While within the tissues, the foreign body elicited several episodes of pain, swelling and pus discharge for which patient took numerous analgesics and antibiotics with little relief.

Findings: Facial asymmetry with swelling around the left zygomatic region with a discharging sinus on the central aspect of the swelling. The immediate surrounding skin appeared darker. An impression of foreign body retention was made. Radiograph showed a linear radiopaque object extending downward from the left zygomatic arch to the lateral side of the left maxilla.Patient could not afford a CT. From the presenting history, examination and the radiograph, foreign body retention was confirmed with a planned exploration. Consent was obtained and exploration under local anaesthesia extracted a 4.5cm broken part of a biro pen from the injury site. The lumen of the biro was filled with blood-stained pus. The area was irrigated thoroughly and sutures were placed.The post op review one year after was uneventful.

Conclusion: Stab injuries to the face can result in retention of the stab object. This necessitates the use of the appropriate imaging technique and a thorough search of the injury site during treatment to prevent prolonged retention of such objects and avoid the complications associated with retention.