Mori S, Fujieda S, Tanaka T, Saito H
Department of Otorhinolaryngology, Fukui Medical University, Matsuoka, Japan.
ORL J Otorhinolaryngol Relat Spec. 1999 May-Jun;61(3):165-8. doi: 10.1159/000027664.
A very rare case of numerous transorbital wooden foreign bodies penetrating into the sphenoid sinus in a 47-year-old male is reported. His right eye was nonreactive to light, and the oculomotor, trochlear and abducens nerves were completely disturbed. Although a minor injury was observed on the inner side of the right eyebrow, the wound was not serious or infectious. Computed tomographic scanning of the orbit and parasinus revealed an isodense linear shadow to muscle and an irregular shadow of the lamina papyracea. However, the findings were difficult to discriminate from an optic canal fracture preoperatively. We detected foreign bodies penetrating the optic nerve rise, which were successfully removed in combination with an endoscopic transethmoidal and transorbital approach. Various and careful imaging examinations are recommended to diagnose and manage paraorbital trauma, when a penetrating wound of the face is observed.
报道了一例极为罕见的病例，一名47岁男性眼眶内有大量木质异物穿透至蝶窦。他的右眼对光无反应，动眼神经、滑车神经和展神经完全受损。虽然在右眉内侧观察到一处轻伤，但伤口并不严重，也没有感染。眼眶和副鼻窦的计算机断层扫描显示，有一条与肌肉等密度的线性阴影以及筛骨纸板的不规则阴影。然而，术前这些表现很难与视神经管骨折区分开来。我们检测到异物穿透视神经隆起，通过鼻内镜经筛窦和经眶入路成功取出异物。当观察到面部有穿透伤时，建议进行各种仔细的影像学检查以诊断和处理眶周创伤。
