Corps étranger intra-orbitaire végétal : à propos d’un cas

Traumatic Intraconal Foreign Body: Report of an Injury Corrected With Combined Surgical and Endoscopic Treatment

BACKGROUND

Management of penetrating ocular splinter injuries is very controversial. Penetrating wounds of the orbit represent a complex therapeutic problem that requires a multidisciplinary approach. Endoscopic approaches to the orbit are currently performed through the lamina papyracea to access the medial part, or through large orbitotomies to access the lateral part.

OBJECTIVE

To describe a novel combined approach to the lateral part of the orbit.

METHODS

Clinical and surgical findings of intraorbital foreign body removal are presented. A minimal supraorbital osteotomy was performed, combined with endoscopic intraorbital dissection.

RESULTS

The foreign body was removed, no postoperative complications were reported, and visual acuity increased from 2/10 preoperatively, to 8/10 one month after surgery.

CONCLUSION

The present technique can be considered a safe and novel surgical approach to access the retrobulbar space and to treat the pathology of this anatomic region.

[An unusual foreign body in the orbit]

INTRODUCTION

Foreign bodies in the orbit are rare. They can generate more or less serious complications depending on their nature and size. We report an exceptional case of a bulky foreign body in the orbit (the tip of a pen), which did not lead to any complication.

OBSERVATION

A 13-year-old child presented with a right orbital trauma caused by a pen. He consulted 3 months later when a small palpebral swelling appeared. The CT scan showed the presence of a foreign body on the orbital floor. Wound debridement allowed extracting the tip of a pen measuring 3.5cm without any complication. There were no postoperative complications.

DISCUSSION

The originality of this observation is two-fold; the singularity of the foreign body and its total harmlessness in spite of its large size. However, orbital trauma and a secondary orbital syndrome must lead to emergency imaging.