Intraoperative fluoroscopy-guided removal of orbital foreign bodies

Could Radiographs Be More Helpful in the Removal of an Intraorbital Foreign Body Than a Surgical Navigation System? A Neurosurgical Case Report

Intraorbital foreign body (IOFB) is a vision-threatening condition that requires careful management. IOFB can manifest clinically from asymptomatic up to severe inflammation and blindness. Diagnosis and treatment are determined by the nature of the IOFB. The type, location, and complications related to the IOFB are taken into consideration when planning the surgery. Here, we report the case of a male in his 20s who was admitted to our clinic with a computed tomography (CT) scan which verified the presence of an IOFB. The patient underwent surgery and the IOFB was removed. Using a surgical navigation system (SNS), it was difficult to pinpoint the IOFB precisely during surgery. We took radiographs with a C-arm to improve our orientation and locate the IOFB. The patient recovered uneventfully, and no issues were noticed one month following surgery. This case report highlights the selection of treatment methods and demonstrates when radiographs can be more helpful than an SNS in the removal of the IOFB.

Facilitating the removal of a foreign body in the tongue by intraoperative ultrasound guidance: A case report

The presence of soft tissue foreign bodies (FBs) presents a substantial concern due to their potential to induce both acute and chronic pain as well as tissue irritation. This case report documents the admission of a 25-year-old female with a history of bur fractures during endodontic treatment, accompanied by signs of infection. The clinical examination and radiographic assessment revealed an embedded foreign body within her tongue. The surgical procedure was informed by repeated ultrasound scans through the incision, facilitating precise targeting. Intraoperative ultrasound enables the accurate detection of submucosal foreign bodies in dynamic tissues like the tongue and facilitates focused and image-guided dissection, thereby decreasing surgical trauma to the delicate soft tissues.

Clinical observation on removal of small foreign bodies touching the optic nerve in the deep orbital region: a case series

PURPOSE

Five patients presented to our institution with deep intraorbital foreign bodies adjacent to the optic nerve. We removed all foreign bodies by lateral orbitotomy to evaluate the treatment and the benefits of their extraction.

METHODS

The clinical outcomes of the five patients were retrospectively analyzed.

RESULTS

Radiology in all five patients revealed small foreign bodies touching the optic nerve in the deep orbital region. All patients also suffered from significant secondary psychological disturbances, these including anxiety and altered sleep patterns. They had become preoccupied with a strong desire to remove the intraorbital foreign bodies [IFB]. In this cohort, two had no light perception before surgery, another two had light perception, and one had hand motion perception as well as vitreous hemorrhage that had been plugged with silicone oil in other hospital. All foreign bodies were removed via lateral orbitotomy. Visual acuity improved after the operation in only three cases. However, the psychological well-being of all five patients improved.

CONCLUSIONS

Consideration should be given to removal of intraorbital foreign bodies adjacent to the optic nerve, even where a significant degree of vision has already been lost. Furthermore some patients can achieved vision improvement and such surgery can frequently address the significant psychological disturbance that can be associated with such orbital foreign bodies.