• Kyle P O'Connor, Ali H Palejwala, Robert G Briggs, Landon Massoth, Jimmy L Argo, and Chad A Glenn.
• Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
• World Neurosurg. 2019 Jun 1; 126: 21-23.

BackgroundPenetrating injuries are dangerous because they can damage intracranial structures. Removal of the object carries this same risk of injury, so neurosurgeons often visualize the injury via craniotomy during removal.Case DescriptionThis report illustrates the case of a 41-year-old man who had a penetrating injury with a knife that started in the left nasal passage and extended to the parasellar region. Computed tomography angiography revealed an associated sphenoid fracture and showed the tip of the knife within the parasellar space with preservation of the internal carotid artery, ophthalmic artery, optic nerve, and pituitary gland. The patient was taken to the operating room for a right pterional craniotomy and the knife was removed in the operating room in a combined effort between neurosurgery and otorhinolaryngology.ConclusionsThe patient progressed well without complications postoperatively and was discharged 5 days later. We provide a report with video showing our surgical approach for removal of a penetrating object through the tuberculum sellae.Copyright © 2019 Elsevier Inc. All rights reserved.

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