受伤8个月后经鼻内镜手术并借助图像引导导航系统取出锥内子弹：1例病例报告
Removal of intraconal bullet through endoscopic transnasal surgery with image-guided navigation system 8 months after injury: a case report.
作者信息
Promsopa Chakapan, Prapaisit Usaporn
机构信息
Division of Allergy and Rhinology, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, 90110, Thailand.
出版信息
J Med Case Rep. 2019 Mar 17;13(1):65. doi: 10.1186/s13256-019-2007-x.
BACKGROUND
Lodgment of a bullet within the orbit is uncommon. The decision to remove these objects poses a challenge to surgeons due to a high risk of complications. Currently, endoscopic transnasal surgery with navigator assistance facilitates the localization of foreign bodies allowing their safe removal with minimal surrounding tissue damage or optic nerve injury.
CASE PRESENTATION
We describe a case of a 26-year-old Thai woman with a chronic intraorbital foreign body located within her medial intraconal space. The chronic intraorbital foreign body was successfully removed by endoscopic transnasal surgery, combined with assistance from a navigation system, 8 months after injury without any damage to her eye or disturbance in vision.
CONCLUSION
Intraconal foreign bodies, such as bullets, are a chronic problem and should be observed in the long term; prompt surgical removal should be performed if indicated.
背景
子弹嵌入眼眶内的情况并不常见。由于并发症风险高，决定取出这些异物对外科医生来说是一项挑战。目前，在内镜导航辅助下经鼻手术有助于定位异物，从而能够在对周围组织损伤最小或对视神经损伤最小的情况下安全取出异物。
病例报告
我们描述了一名26岁泰国女性的病例，其眼眶内慢性异物位于眶内侧圆锥内间隙。受伤8个月后，通过内镜经鼻手术并在导航系统辅助下成功取出了眼眶内慢性异物，未对其眼睛造成任何损伤，视力也未受影响。
结论
圆锥内异物，如子弹，是一个慢性问题，应长期观察；如有指征，应及时进行手术取出。
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