Aljabber Sara J, Alghamdi Abdulaziz M, Faidah Dania E, Allarakia Yousof Fahad, Abdulqader Sarah Bin, Alzahrani Gmaan A
Department of Neurosurgery, King Fahad Medical City Hospital, Riyadh, Saudi Arabia.
College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Surg Neurol Int. 2024 Jun 28;15:219. doi: 10.25259/SNI_324_2024. eCollection 2024.
Intraorbital wooden foreign bodies (IOWFBs) constitute a relatively rare ocular trauma. Clinically, it can be difficult to diagnose them due to their wide variety of clinical manifestations. In addition, radiologic diagnosis of IOWFBs is always uncertain and challenging since their low density and low intensity on initial images are identical to air and fat. Therefore, IOWFBs are commonly missed and may not be confirmed for days or months after the initial injury. This article endeavors to contribute to the existing literature on IOWFBs by adding a case of an unusual occurrence of retained wood penetrating the inferior orbital fissure (IOF). To date, there have been no documented instances of a similar occurrence in this particular anatomical location.
A 58-year-old female with a history of trauma sustained by a slipping accident 10 months before her referral to our hospital. She underwent multiple surgeries and was referred to us due to persistent right eye pain, periorbital swelling, recurrent eye discharge, and inferior orbital paresthesia. The imaging revealed a retained foreign body located in the right orbital floor inferior to the inferior rectus muscle extending to the sub-temporal fossa through the IOF. The residue was successfully removed without complications.
A history of trauma followed by persistent symptoms should raise the suspicion of a retained foreign body, regardless of the severity of trauma or the time between trauma and clinical presentation. Appropriate and timely imaging, followed by surgical removal, remains the cornerstone of treatment with a favorable prognosis.
眼眶内木质异物（IOWFBs）是一种相对罕见的眼外伤。临床上，由于其临床表现多种多样，诊断可能会很困难。此外，IOWFBs的放射学诊断一直存在不确定性且具有挑战性，因为其在初始图像上的低密度和低强度与空气和脂肪相同。因此，IOWFBs常常被漏诊，可能在初始损伤后数天或数月都无法确诊。本文通过增加一例罕见的木质异物滞留并穿透眶下裂（IOF）的病例，为现有的关于IOWFBs的文献做出贡献。迄今为止，在这个特定解剖位置尚未有类似情况的记录实例。
一名58岁女性，在转诊至我院前10个月因滑倒事故有外伤史。她接受了多次手术，因右眼持续疼痛、眶周肿胀、反复眼部分泌物及眶下感觉异常而转诊至我院。影像学检查显示一个滞留异物位于右眼眶底部，在眼直肌下方，通过眶下裂延伸至颞下窝。异物残余物被成功取出，无并发症发生。
有外伤史且伴有持续症状时，应怀疑有异物滞留，无论外伤的严重程度或外伤与临床表现之间的时间间隔如何。适当且及时的影像学检查，随后进行手术取出，仍然是治疗的基石，预后良好。
