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Management of intraorbital metallic foreign body with lateral orbitotomy and c-arm guiding surgery: a challenging case

Abstract

Introduction: Orbital trauma is an emergency condition that often occurs with increasing mobility and industry. An intraorbital foreign body is one of the traumas that occur in the orbit. An intraorbital foreign body is an entrapment of corpus alienum in the orbital cavity, either accompanied by orbital fracture or not accompanied by fracture.

Case Report: We report a 31-year-old man who suffered ocular trauma and had a rusty hammer splinter foreign body stuck in the orbital cavity of the right intraconal region. The patient was found with an initial suspicion of IOFB, but investigations with a head CT scan could not detect the presence of IOFB. The treatment of choice for this patient is a lateral orbitotomy with C-arm fluoroscopy guiding. Panuveitis occurred in the patient's eye after the extraction of the corpus alienum was performed. Suspicion of inflammation caused by siderosis bulbi cannot been ruled out.

Discussion: Suspicion of the presence of an intraorbital foreign body can be based on several clinical symptoms and patient complaints and the presence of port d' entry through the cornea, sclera, or eye adnexa. Management of intraorbital foreign body depends on the type of foreign body, its location in the orbit and the presence or absence of accompanying complications. Lateral orbitotomy with c-arm guiding in this patient successfully extracted an intraconal foreign body using the S-Stallar Wright incision technique. Avoid ocular complications due to intraorbital foreign body retention include orbital cellulitis, chronic cutaneous fistula, optic neuropathy, extraocular muscle rupture, bulbar perforation, intracranial penetration, intraorbital arteriovenous fistula, and chorioretinal atrophy.

Conclusion: The management of intraorbital foreign bodies depends on the type of retained foreign body, whether inert or non-inert/toxic. So that it can prevent patients from threatening intraorbital and intraocular complications.

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How to Cite

Ratnasari, N. L. M. N., Putu Yuliawati, Ni Made Laksmi Utari, I Gusti Ayu Made Juliari, & I Made Agus Kusumadjaja. (2023). Management of intraorbital metallic foreign body with lateral orbitotomy and c-arm guiding surgery: a challenging case. Intisari Sains Medis, 14(3), 1008–1015. https://doi.org/10.15562/ism.v14i3.1850

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Ni Luh Made Novi Ratnasari
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Putu Yuliawati
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Ni Made Laksmi Utari
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I Gusti Ayu Made Juliari
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I Made Agus Kusumadjaja
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ISM Journal