Endoscopic Coil as a Foreign Body in the Maxillary Sinus: A Complication of Endoscopic Embolization for Epistaxis

Background Endovascular embolization is a well-established alternative to surgery for control of severe epistaxis. Coils typically target the internal maxillary artery for embolization and subsequent extrusion is a theoretical possibility. Here, we present a case report of endoscopic coils noted as a foreign body within the maxillary sinuses. Coil extrusion has been described in the literature, but there are no reports of such extrusion into the maxillary sinus and should be recognized as a potential complication of endoscopic embolization for control of epistaxis.

Case Report The patient is a 22-year-old woman seen for right maxillary sinusitis. She had a history of prior maxillary mandibular advancement surgery and developed severe epistaxis postoperatively. She was found to have a pseudoaneurysm at the sphenopalatine branch of the right internal maxillary artery and underwent successful embolization. Postoperatively, she developed right maxillary sinusitis with pain and pressure over her right maxillary sinus. CT scan showed opacification and presence of a radio-opaque material in the sinus. Endoscopic right maxillary antrostomy was performed and the coil was seen in the antrum, and then removed without complications. Postoperatively, her symptoms resolved.

Discussion We present a case of a coils placed for epistaxis that migrated to the maxillary sinus and caused sinusitis. The patient required endoscopic removal with no recurrence of the epistaxis. It is important to be aware of possible migration of coils following IMA or SPA embolization for control of epistaxis. In this case, the coil migrated into the maxillary sinus causing recalcitrant maxillary sinusitis.

Publication History

Publication Date:
02 February 2018 (online)