Introduction: We present our clinical experience in a case of orbital fracture occurred as a result of a penetrating foreign body in left midfacial segment causing orbital floor fracture and a fracture of median wall of the left maxillary sinus. Case presentation: We report an unusual clinical case of a 66-year-old Caucasian man, received emergency in the ENT clinic at the University Hospital "Tzaritza Joanna - ISUL" with work-related blunt orbital and facial trauma. A clinical examination and a computed tomography revealed a penetrating foreign body (tree branch split into three parts) from orbit in the left maxillary sinus, which is traversed the medial wall of the left maxillary sinus and penetrated the lower turbinate. Conclusion: In indicated case, attached combined access allowed us to achieve an adequate exposure to remove the foreign body and perform reconstruction of the injured regions, leading to very good results if the anatomical and functional properties of the orbit and its contents are respected. Careful consideration of detailed clinical history as well as choosing an appropriate medical imaging modality as computed tomography should always be kept in mind in order to have a prompt and adequate diagnosis and start early treatment to reduce complications. cardio-vascular endurance in patients with COPD as it is less stressful and easier to apply compared to SMWT.
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