Foreign bodies within the para-nasal sinuses are a reported cause of chronic unilateral rhinosinusitis. The most commonly cited cause is of dental origin. One previously reported case cited a foreign body from the repair of an orbital blow-out fracture. Suspicion of a sinugenic foreign body cause may only be aroused by a thorough history and examination, usually confirmed by imaging. We report a case of 57-year-old man was referred to ENT with persistent right nasal blockage and catarrh for over a decade. It transpired that he had previously had surgery using a silastic graft for a blow-out fracture. This is only the second reported case in the world literature of recurrent sinusitis from a graft placed to repair an orbital blow-out. A history of significant facial injuries should be considered and then actively investigated in unilateral chronic rhinosinusitis. The advent of ultra-low dose sinus computed tomography scans may encourage a more inquisitive surgeon to further investigate rhinosinusitis with imaging.