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眶内木质异物:病例系列及文献综述

Intraorbital wooden foreign bodies: case series and literature review.

作者信息

You Ya-Yan, Shi Bing-Jie, Wang Xin-Yan, Chen Jin, Wang Zheng-Rong, Wang Xing-Hua, Jiang Fa-Gang

机构信息

Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.

出版信息

Int J Ophthalmol. 2021 Oct 18;14(10):1619-1627. doi: 10.18240/ijo.2021.10.21. eCollection 2021.

Abstract

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 [, magnetic resonance imaging (MRI) or computerized tomography (CT)], and timely and completely elimination of IOWFBs.

摘要

眼眶内木质异物(IOWFBs)是一种相对罕见的眼外伤,属于眼眶内异物(IOFBs)的特殊类型。由于其罕见性,关于IOWFBs的数据必须从病例报告或小病例系列中获取。在此,我们报告了5例IOWFBs病例并回顾了相关文献,这可以提供关于IOWFBs临床表现、诊断和手术治疗的全面信息。结合已发表的文献,在我们增加5例病例后,共统计了51例独立病例。其中,男性患者35例,女性患者16例;平均年龄为27.3±18.2(范围1 - 66)岁。显然,这种疾病似乎主要发生在中青年人群中。由于IOWFBs临床表现和影像学特征的多样性,初诊时常常发生误诊和漏诊。延迟诊断可能导致IOWFBs引起眼眶感染的高风险。手术是大多数患者的首选治疗方法;然而,既往手术中的漏诊和异物残留不容忽视。因此,准确的诊断取决于详细的外伤史、仔细的眼部检查、对临床表现的密切观察、正确的影像学诊断[磁共振成像(MRI)或计算机断层扫描(CT)]以及及时、彻底地清除IOWFBs。

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本文引用的文献

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Case Rep Ophthalmol Med. 2021 Mar 30;2021:6645952. doi: 10.1155/2021/6645952. eCollection 2021.
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Surg Neurol Int. 2020 Jun 20;11:158. doi: 10.25259/SNI_204_2020. eCollection 2020.
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Eyelid and orbital trauma for the primary care physician.眼科和眼眶创伤的初级保健医生。
Dis Mon. 2020 Oct;66(10):101045. doi: 10.1016/j.disamonth.2020.101045. Epub 2020 Jul 1.
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Unrecognized intraorbital wooden foreign body.未识别出的眶内木质异物。
Arch Craniofac Surg. 2018 Dec;19(4):300-303. doi: 10.7181/acfs.2018.02047. Epub 2018 Dec 27.

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