Unusual Intra-Orbital Foreign Body Removed by a Unique Surgical Approach
Main Article Content
Abstract
INTRODUCTION
A retained intra-orbital foreign body can give rise to serious complications. This case report highlights an interesting case where a metallic foreign body remained lodged inside the orbit for over a year, unbeknownst to the patient, and was eventually detected and surgically extracted.
CASE REPORT
We report a case of a 57-year-old female who presented with mild pain of the left orbit following an injury with an umbrella after a fall one year ago. Following a near normal physical examination, on radiological evaluation we found a linear, presumably metallic foreign body lodged into the orbit, without piercing the globe. An inferolateral orbitotomy approach was used to gain adequate exposure and facilitate the removal of a 3.5 cm metallic remnant of an umbrella stick.
DISCUSSION
The management of intra-orbital foreign bodies poses several challenges. The choice between conservative and surgical management is one of them. CT scan is the diagnostic tool of choice. When surgical removal is indicated, a suitably planned approach facilitates extraction of the foreign body with minimal morbidity. This rare case is testament to the fact that although it may not be part of their conventional realm, carefully selected intra-orbital foreign bodies can be efficiently managed surgically by ENT professionals.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Fulcher TP, McNab AA, Sullivan TJ. Clinical features and management of intraorbital foreign bodies. Ophthalmology. 2002 Mar 1;109(3):494-500
Moretti A, Laus M, Crescenzi D, Croce A. Peri-orbital foreign body: a case report. Journal of Medical Case Reports. 2012 Dec;6(1):1-4
Hudson DA. Impacted knife injuries of the face. British journal of plastic surgery. 1992 Jan 1;45(3):222-4
Finkelstein M, Legmann A, Rubin PA. Projectile metallic foreign bodies in the orbit: a retrospective study of epidemiologic factors, management, and outcomes. Ophthalmology. 1997 Jan 1;104(1):96-103
Callahan AB, Yoon MK. Intraorbital foreign bodies: retrospective chart review and review of literature. International Ophthalmology Clinics. 2013 Oct 1;53(4):157-65
Cooper W, Haik BG, Brazzo BG. Management of orbital foreign bodies. Smith's Ophthalmic Plastic and Reconstructive Surgery. St. Louis: Mosby. 1998:260-9
Ho VH, Wilson MW, Fleming JC, Haik BG. Retained intraorbital metallic foreign bodies. Ophthalmic Plastic & Reconstructive Surgery. 2004 May 1;20(3):232-6
Siedlecki AN, Tsui E, Deng J, Miller DM. Long-term retention of an intraorbital metallic foreign body adjacent to the optic nerve. Case Reports in Ophthalmological Medicine. 2016 Oct 12;2016
Markowski J, Dziubdziela W, Gierek T, Witkowska M, Mrukwa-Kominek E, Niedzielska I, Paluch J. Intraorbital foreign bodies–5 own cases and review of literature. Otolaryngologia Polska. 2012 Jul 1;66(4):295-300
Varty SP, Gupte MA, Jehangir RP, Ogale SB. Intraorbital Foreign Body Removal by Lateral Orbitotomy Approach. Bombay Hospital Journal July 2006; 48 (3). https://www.bhj.org.in/journal/2006_4803_july/html/case_rep_500_502.html