Intraorbital Wooden Foreign Body Research Articles

Removal of Intraorbital Foreign Body by Transnasal Endoscopic Approach Removal of Intraorbital Foreign Body by Transnasal Endoscopic Approach.

Foreign bodies in the intra-orbital area are a rare occurrence. It can be metallic or non-metallic. Intra-orbital foreign bodies can present with a variety of complications depending upon its size and location. We report a case of intra-orbital foreign body which was successfully removed by trans-nasal endoscopic approach.A 12 year old boy with an intra-orbital wooden foreign body in the medial extra-conal space was presented three days posttrauma. He had normal visual acuity but there was painful restriction of eye movement. Foreign body was removed and pus drained by trans-nasal endoscopic approach. Post operatively he gradually regained his eye movements. Post operatively patient had complete recovery of eye movements. Traditionally intra-orbital foreign bodies were removed by external approach. With advancement in technology medial intra-orbital foreign bodies can be removed by trans-nasal endoscopic approaches.

Extracted Intra-Orbital Wooden Foreign Body Missed by the Primary Clinician

Extracted Intra-Orbital Wooden Foreign Body Missed by the Primary Clinician

Clinical analysis of 96 patients with intraorbital foreign bodies: A 10-year retrospective study.

To investigate the clinical manifestations, diagnosis, and surgical treatment of intraorbital foreign bodies (IOFBs). Patients with IOFBs were enrolled from Wuhan Union Hospital between January 2011 and January 2021. Demographic and clinical information was extracted, including gender, age, cause and entrance of the trauma, material, size and quantity of foreign body, visual function, ocular complications, imaging findings, and surgical intervention. The patients were divided into two groups according to the timeline, group A (from January 2011 to December 2015, n = 39) and group B (from January 2016 to January 2021, n = 57). The 96 patients (81 men and 15 women) were enrolled in this series, with a median age of 39.5 (1.6-76.0) years. Work-related injuries were the cause of IOFBs in 45 individuals (46.9%). Three patients (3.3%) presented severe visual impairment, and 39 patients (42.4%) presented blindness. The majority of foreign bodies were metal (44.8%), followed by wood (26.0%). Computed tomography (CT) and magnetic resonance imaging (MRI) were performed, respectively, on 89 (92.7%) and 21 (21.9%) patients with IOFBs, in which the detection rate was 80.9% for CT and 81.0% for MRI. Among the 25 patients with intraorbital wooden foreign bodies (IOWFBs), the utilization and detection rates of MRI were 50.0% and 40.0% in group A, and 93.3% and 92.9% in group B, with significant differences in both rates between the two groups (both P < 0.05). The IOWFBs detection rate in MRI was significantly higher than that in CT (78.9% vs. 45.8% overall and 92.9% vs. 53.5% in group B). The detection rates of IOFBs and IOWFBs in initial surgery were statistically different between the two groups, of which the rates were 84.6% and 40.0% in group A and 98.2% and 93.3% in group B. The reoperation rate of IOWFBs in group B (20.0%) was significantly lower than that in group A (70.0%). IOFBs were mainly caused by work-related injuries and might lead to serious visual impairment. The application and detectability of MRI in IOWFBs improved in recent years, and MRI presented better detectability than CT in diagnosing IOWFBs. Thus, MRI should be recommended despite negative CT findings.

A Computed Tomography Scan Near Miss of an Intraorbital Wooden Foreign Body.

When intraorbital wooden foreign bodies are missed, the consequences can be devastating. While the gold standard diagnostic imaging is computed tomography (CT), it has low sensitivity. We present a 61-year-old man with a bamboo injury to his right eye. He underwent two CT scans that failed to raise the possibility of intraorbital foreign bodies. Upon additional review, a rectangular-shaped pocket of air was identified in the orbit which was most consistent with wooden foreign bodies based on the clinical history. A combined mid-lid approach followed by a transconjunctival and transcaruncular extension were employed to remove several wooden splinters. Postoperatively, due to recurrent orbital compartment syndrome, he required a second decompression with an inferior rim osteotomy. He had good recovery at 3 months follow-up. Overall, intraorbital wooden foreign bodies are challenging to diagnose due to imaging limitations. Providing a clear history and suspected diagnosis to radiology is critical for diagnosis.

Neglected preseptal wooden foreign body: A rare presentation

Intraorbital foreign bodies can be metallic, non metallic and organic in their composition. Organic foreign bodies especially wooden, can act as a nidus of infection if left in situ. The diagnosis of a wooden foreign body is quite difficult radiologically because of their radiolucent nature so, they require high degree of suspicion. We report this case of a patient who presented with non healing persistent discharging sinus from left eye lateral part of the upper lid just above the eye lid margin following trivial trauma 6 months back. Based on the clinical evaluation and radiological evidence we made a diagnosis of retained wooden intraorbital foreign body. LE orbit surgical exploration and removal of wooden foreign body was done and the patient responded well postoperatively.

Missed Intra-Orbital Wooden Foreign Body

Intra-orbital wooden foreign bodies (IOFB) are always a diagnostic challenge. Those are entered by unmarked trivial injuries, as in our case, may become even more difficult, and maybe notorious and remain quiescent for a long time, before presenting with a variety of complications. It may lead to a more diagnostic dilemma, which can especially occur with wooden foreign bodies (FB) due to the variable nature of radio-imaging. The lack of clinical suspicion may lead to a series of errors both in diagnosis and management, subjecting the patient to unnecessary intervention. In this case report, we will describe a missed wooden foreign body that, after a long quiescent period, presented as an intra-orbital mass.

Intraorbital wooden foreign bodies: case series and literature review.

Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma, which occupy a special type of intraorbital foreign bodies (IOFBs). Data regarding IOWFBs must be obtained from case reports or small case series due to their rarity. Here, we reported 5 cases of IOWFBs and reviewed the related literatures, which could provide comprehensive information regarding the clinical manifestations, diagnosis, and surgical treatment of IOWFBs. Combined with the published literature, a total of 51 independent cases were counted after we added 5 cases. Among them, the number of male and female patients was 35 and 16 respectively; the mean age was 27.3±18.2 (range 1-66)y. Obviously, the disorder seemed to occur mainly in young and middle-aged people. Because of the diversity in the clinical manifestations and imaging characteristics of IOWFBs, misdiagnosis and missed diagnosis often occur during the initial visit. Delayed diagnosis may lead to a high risk of orbital infection caused by IOWFBs. Surgery is the treatment of choice for most patients; however, the missed diagnosis and residue of foreign bodies after previous surgery cannot be ignored. Therefore, an accurate diagnosis is governed by the detailed trauma history, careful ocular examination, close observation of clinical manifestations, correct imaging diagnosis [e.g., magnetic resonance imaging (MRI) or computerized tomography (CT)], and timely and completely elimination of IOWFBs.

Diagnosis and Management of Wooden Foreign Bodies in the Orbit: A Case Report

The diagnosis and management of intraorbital foreign bodies are challenging for surgeons. Foreign bodies made of wood and those located close to the optic nerve are especially difficult to manage. Herein, we report our experience with the diagnosis and management of intraorbital wooden foreign bodies utilizing magnetic resonance imaging (MRI). A 50-year-old man presented to the emergency room with a laceration on his left upper eyelid. No foreign bodies were visible through the laceration, and computed tomography findings showed only evidence of cellulitis with abscess formation. Despite drainage and antibiotics, the cellulitis worsened; subsequently, we found multiple wooden foreign bodies on MRI. Surgical removal was performed, excluding those in the intraconal space to avoid optic nerve damage. The patient recovered well and has not experienced any ophthalmic complications at 1 year of follow-up.

A case of a large intraorbital wooden foreign body perforating the lateral orbital wall of left eye in a child

A 6-year-old child visited our institute with a history of foreign body that stuck in her eye. Computed Tomography (CT) scan report revealed hypodensity embedded in the left lateral orbital wall, abutting and compressing the globe of the left eye with displaced comminuted fracture. We performed a procedure of removal of foreign body from the eye, a procedure that was performed with great difficulty and precision given the sensitivity. On the postoperative day, nil foreign-body was noted in CT scan and there was chemosis and full eyeball movement. The cornea was clear, anterior chamber quiet, the pupil normally reactive. Dilated fundoscopy was normal. We report here a challenging case of a large intraorbital wooden foreign body in the left orbit of a child perforating the lateral wall of the left orbit, which on surgical removal the entire eyeball was found intact and normal. The patient's injury could be considered novel as it was unseen at the hospital and post operatively the anterior and posterior segment was found to be normal. This explain the rarity of the case and hence it hit our inquisitiveness.

Intraorbital wooden foreign body — a case report

Background: Wood as an intraorbital foreign body (IOFB) is infrequent, and as it is organic matter patients represent an increased risk of infection. The aim of this study is to report the complexity of treatment of patient with a wooden IOFB. We describe a case of a 67-year-old male with a wooden IOFB. Case report: On referral, the patient presented with exophthalmos, pain, blurry vision and discharge from his left eye was admitted to the Department of Ophthalmology, Medical University of Gdansk. The previous evening, he fell with his face down. Computed tomography revealed a low-density IOFB of approximately -980 Hounsfield Units, sized 62 × 8 mm, in the area of left orbit, ethmoid and sphenoid sinus. Subsequently, the IOFB was removed under general anaesthesia. After three days of empirical antibiotic therapy, the patient was discharged with a switch to oral antibiotics. Shortly after the conversion to oral therapy, he developed an orbital inflammatory syndrome and was readmitted to the hospital. His condition improved after readministration of parenteral antibiotics. Conclusion: This case demonstrates that wooden IOFBs should be treated with caution. Parenteral antibiotic delivery leads to higher serum levels than with oral intake, and in this case, was essential in preventing infection after IOFB removal.

Intra-orbital Wooden Foreign Body

Intra orbital wooden foreign body (IOWFB) injuries are common cause of visual loss. The diagnosis is difficult, it may be missed from the imaging perspective. A case series is reviewed between 2013 and 2017. Of the 4 cases, 3 were caused by tree branch and 1 by bamboo. The postoperative vision was improved in 75%, but not in 25% subjects due to optic nerve damage. To be strongly suspected intra orbital wooden foreign body when the intra orbital density below of the surrounding intra orbital fat on CT. All the intra orbital wooden foreign body were removed successfully without any complications.

Optik sinire uzanım gösteren tahta bir yabancı cismin transkonjonktival medial anterior orbitotomi ile çıkarılması: Bir olgu sunumu

Intraorbital foreign bodies can be classified into organic or inorganic according to their chemical composition. Wooden is inorganic in nature and is a rare, but serious form of intraorbital foreign body injuries. Evaluation and management of intraorbital wooden foreign bodies are highly challenging and can lead to severe orbital complications. In this paper, we report a case of a 33-year old man who presented with a penetrating wooden foreign body injury to the left orbit. Computed tomography revealed a linear shaped foreign body extending from left supraorbital ridge to the intraconal area. The tip of the foreign body was touching to the optic nerve without disrupting its integrity. The patient underwent transconjunctival medial anterior orbitotomy and the wooden foreign body was found to be located close proximity to the optic nerve in intraconal space. A 7cm wooden stick was removed completely with controlled traction. Postoperative recovery was uneventful with normal ophthalmic examination. Transconjunctival medial anterior orbitotomy is a useful and effective method for the removal of intraorbital wooden foreign bodies located in intraconal space.

Unrecognized intraorbital wooden foreign body.

Intraorbital wooden foreign bodies may present difficulties in diagnosis due to their radiolucent nature. Delayed recognition and management can cause significant complications. We present a case report that demonstrates these problems and the sequela that can follow. A 56-year-old man presented with a 3-cm laceration in the right upper eyelid, sustained by a slipping accident. After computed tomography (CT) scanning and ophthalmology consultation, which revealed no fractures and suggested only pneumophthalmos, the wound was repaired by a plastic surgery resident. Ten days later, the patient’s eyelid displayed signs of infection including pus discharge. Antibiotics and revisional repair failed to solve the infection. Nearly 2 months after the initial repair, a CT scan revealed a large wooden fragment in the superomedial orbit. Surgical exploration successfully removed the foreign body and inflamed pocket, and the patient healed uneventfully. However, the prolonged intraorbital infection had caused irreversible damage to the superior rectus muscle, with upgaze diplopia persisting 1 year after surgery and only minimal muscle function remaining. We report this case to warn clinicians of the difficulties in early diagnosis of intraorbital wooden foreign bodies and the grave prognosis of delayed management.

Intraorbital Wooden Foreign Body with Intracranial Extension : A Case Report

&#x0D; &#x0D; &#x0D; Purpose : The aim of this study is to report a case of intraorbital wooden foreign body with intracranial extension to the frontal lobe and its management. Method : This is a descriptive study: A 53 year-old male referred due to wooden stick stucked in the orbital cavity causing protruding eyeball and vital sign instability. &#x0D; Result : Right eye examination revealed light perception visual acuity, with bad light projection and bad color perception, inwardly folded upper eyelid, proptosis, conjunctival chemosis, corneal erosion and edema, dilated pupil with sluggish pupillary light reflex and limited ocular movement in all direction. Vital sign was unstable with decreasing blood pressure, increasing temperature and heart rate. CT Scan showed complete fracture of the orbital roof due to penetration of the wooden stick, pneumoencephalus, cerebral edema and hematoma. Emergency craniotomy was performed to remove the penetrating wooden stick and bone segment in the frontal lobe and fracture repair. Ophthalmologist pulled the remaining stick, released the superior rectus muscle and repaired the lacerated eyelid. Outcome visual acuity was no light perception with lagophthalmos and limited ocular motility. Patient was admitted to Intensive Care Unit one day post-operatively and treated with systemic and topical antibiotic. &#x0D; Conclusion : Any case presenting with intraorbital foreign body must undergo immediate neuroimaging to exclude any intracranial extension, especially in patients with worsening general condition. &#x0D; &#x0D; &#x0D;

Clinical diagnosis and treatment of intraorbital wooden foreign bodies

PurposeThe intraorbital wooden foreign body is often misdiagnosed or missed on computed tomography (CT) scan, due to the invisible or unclear images. The residual foreign bodies often occur during surgical removal. The clinical manifestations, imaging features and treatment of intraorbital wooden foreign bodies were discussed in this study. MethodWe retrospectively analyzed 14 cases of intraorbital wooden foreign bodies managed at our hospital between January 2007 and May 2015. All patients underwent orbital CT examination before surgery, and surgery was performed under general anesthesia with orbital wound debridement and suture, as well as exploration and removal of wooden foreign bodies. ResultsAt first, 11 cases underwent removal of foreign bodies, including 1 case with incomplete removal and then receiving a secondary surgery. Foreign bodies were not found in three cases with preoperative misdiagnosis and orbital MRI found residual foreign bodies in the orbit. Operations were performed via primary wound approach in eight cases, conjunctival approach in two cases, and anterior orbitotomy in four cases. Postoperatively, one case was complicated with eye injuries, three cases with ocular muscle injuries, eight cases with visual loss, and eight cases with orbital abscess. The length of foreign bodies ranged from 1.8 cm to 11.0 cm. The maximum of four foreign bodies were removed at the same time. ConclusionBecause the imaging of orbital wooden foreign bodies is complex and varied, MRI should be combined when they are invisible on CT scan. At the same time injuries trajectory and clinical manifestations of patients should be taken into account. Surgical exploration should be extensive and thorough, and foreign bodies and orbital abscess must be cleared.

INTRAOCULAR FOREIGN BODY-A PECULIAR CHALLENGE

AbstractIntraorbital foreign bodies often present a confusing clinical picture and managing them remains a challenging experience to the oral and maxillofacial surgeons. Wooden foreign bodies are notorious for remaining quiescent for a long time, before presenting with a variety of complications. The wound of entry may often be small and self-sealing. Wooden foreign bodies also show a propensity to break during attempted removal. Intraorbital wood is often not detected by standard diagnostic tests like the computed tomography scan, adding to the diagnostic dilemma. A retained foreign body can give rise to serious complications, the most devastating of which is loss of the eye. This interventional case report of an unusual case of a wooden intraorbital foreign body reviews the clinical features, radiological appearance and surgical management. Details of ocular history, preoperative ocular examination findings including visual acuity, computed tomography findings were noted. Early surgical exploration was carried out with blunt dissection and careful hemostasis. Thus the foreign body extraction greatly influenced the visual prognosis and final outcome of the patient.

Intraorbital Wooden Foreign Body: A Case Report

Intraorbital foreign bodies are one of the commonly encountered orbital problems. They may be sight threatening due to the severity of injury or its complications and even life threatening if not managed appropriately. We present a case of a 24-year old female with history of fall injury from a tree with an impacted intraorbital wooden foreign body. The patient was treated with prophylactic intravenous antibiotics and prompt removal of the foreign body was done under general anesthesia in the operation theatre. The post operative visual recovery was excellent with significant improvement of ocular motility and limited improvement of ptosis. Hence even organic foreign bodies can have good prognosis with timely intervention.DOI: http://dx.doi.org/10.3126/jkmc.v3i3.12248Journal of Kathmandu Medical CollegeVol. 3, No. 3, Issue 9, Jul.-Sep., 2014, Page: 119-121

Intraorbital wooden foreign body: clinical analysis of 32 cases, a 10-year experience

We aimed to describe herein the clinical features, diagnosis and treatment of intraorbital wooden foreign body injuries. A case series review of orbital injuries managed at Trakya University Faculty of Medicine between 2002 and 2012 was performed retrospectively. The clinical analysis of 32 intraorbital wooden foreign body injuries was reviewed. Among the 32 cases, injuries in 16 were caused by a tree branch, in 10 by a pencil, in 5 by a stick, and in 1 by a bush. With respect to preoperative vision, postoperative vision was improved in 69% of patients. Time lapse from injury to presentation was correlated with the size of the foreign body. The subjects were comparable in etiological factor, and distribution of injury according to orbit was as follows: superior 28%, medial 25%, lateral 22%, inferior 16%, and posterior 9%. Computerized tomography (CT) for foreign body was definitive in 72% (n=23) and suggestive in 28% (n=9). The diagnosis of orbital wooden foreign body is difficult because it may be missed clinically and from the imaging perspective. If a foreign body is suspected, optimal patient management should be done. Prior to the surgery, imaging modalities should be maximally utilized. A careful preoperative evaluation, imaging studies, which are event-specific, a high index of suspicion, and rigorous surgery and postoperative care are the keys in the management of orbital wooden foreign body injuries.

Orbitocranial wooden foreign body

We report a case of orbitocranial wooden foreign body, piercing through roof of orbit, frontal sinus and frontal lobe and reaching up to corpus callosum. It was, missed at the time of injury by treating surgeon and removed by us after five months. Meticulous exploration of wound and radiological imaging study of orbital injuries is mandatory at the time of injury as they complement each other in the diagnosis. Unlike metal foreign bodies that are easily diagnosed on radiological imaging, intraorbital wooden foreign bodies are often missed on cursory clinical evaluation and radiodiagnosis. This may result into significant ocular morbidity at a later date.

An unusual case of intraorbital foreign body and its management

A 36-year-old aboriginal female presented following an assault with a wooden fence paling. Examination revealed a wooden object protruding lateral to the left eyebrow. CT scan showed a blow-in fracture of lateral orbital wall and a hypodense foreign body causing indentation of the globe and stretching of the optic nerve. The case was managed successfully with complete recovery of the visual acuity on day 1 post-surgery. This case highlights the importance of prompt removal of large lateral wooden intraorbital foreign body to achieve an excellent visual outcome.